CAJ | 학술논문

目的观察右美托咪定预防小儿扁桃体腺样体切除术全凭静脉麻醉苏醒期躁动的作用.方法将60例全凭静脉麻醉下行择期扁桃体腺样体切除术患儿,随机分为实验组(A组)与对照组(B组),诱导后分别持续静脉泵入右美托咪定每小时0.2 μg/kg和等容量的生理盐水至手术结束.记录患儿手术时间、停药至清醒时间、恢复室滞留时间、到达恢复室即刻改良Aldrete评分、进入恢复室后30 min内根据儿童麻醉后躁动评分(PAED)和改良加拿大东安大略儿童医院疼痛评分量表(m-CHEOPS),每5 min对患儿进行躁动和疼痛评分,所得最高值作为监测有效值.结果实验组与对照组比较,停药至清醒时间、Aldrete评分及恢复室滞留时间的差异无统计学意义(P＞0.05),PAED评分E组[(9.4±1.8)分]显著低于C组[(13.8±2.2)分,P＜0.05],疼痛评分E组[(3.8±0.6)分]显著低于C组[(4.8±0.8)分,P＜0.05].结论右美托咪定可在一定程度上预防小儿扁桃体腺样体切除术全凭静脉麻醉苏醒期躁动的发生.
목적 관찰우미탁미정예방소인편도체선양체절제술전빙정맥마취소성기조동적작용.방법 장60례전빙정맥마취하행택기편도체선양체절제술환인,수궤분위실험조(A조)여대조조(B조),유도후분별지속정맥빙입우미탁미정매소시0.2 μg/kg화등용량적생리염수지수술결속.기록환인수술시간、정약지청성시간、회복실체류시간、도체회복실즉각개량Aldrete평분、진입회복실후30 min내근거인동마취후조동평분(PAED)화개량가나대동안대략인동의원동통평분량표(m-CHEOPS),매5 min대환인진행조동화동통평분,소득최고치작위감측유효치.결과 실험조여대조조비교,정약지청성시간、Aldrete평분급회복실체류시간적차이무통계학의의(P＞0.05),PAED평분E조[(9.4±1.8)분]현저저우C조[(13.8±2.2)분,P＜0.05],동통평분E조[(3.8±0.6)분]현저저우C조[(4.8±0.8)분,P＜0.05].결론 우미탁미정가재일정정도상예방소인편도체선양체절제술전빙정맥마취소성기조동적발생.
Objective To observe the effects of dexmedetomidine on emergence delirium in pediatric adenotonsillectomy under total intravenous anesthesia (TIVA).Methods 60 children undergoing adenotonsillectomy under TIVA were randomly divided into experimental group (group A) and control group (group B).Anesthesia was induced than dexmedetomidine was infused at the rate of 0.2 μg/kg.h in group E and sodium chloride was infused at the same volume in group C after induction.Record the time of operation,drug withdrawal to conscious,retention time of recovery room,and the modified Aldrete score of reaching recovery room,according to the Pediatric Anesthesia Emergence Delirium to mark the delirium of the patient in the future 30 minutes per 5 minutes,the highest score is used to effective value.and at the same time,mark the degree of pain according to the modified Children' s Hospital of Eastern Ontario Pain Scale.Results There was no statistical significance in comparation with group C and group E,the time of drug withdrawal to conscious,retention time of recovery room,and the modified Aldrete score of reaching recovery room (P ＞ 0.05).Pediatric anesthesia emergence delirium (PAED) of group E (9.4 ± 1.8) was significantly lower than group C (13.8 ± 2.2) (P ＜ 0.05),pain of group E (3.8 ± 0.6) was significantly lower than group C (4.8 ± 0.8) (P ＜ 0.05).Conclusion Dexmedetomidine can decrease the incidence rate of emergence delirium in pediatric adenotonsillectomy under TIVA.