中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
2期
69-72
,共4页
右美托咪定%七氟醚%麻醉
右美託咪定%七氟醚%痳醉
우미탁미정%칠불미%마취
Dexmedetomidine%Sevoflurane%Anesthesia
目的：探讨右美托咪定对肱骨髁上骨折患儿手法复位术后七氟醚麻醉苏醒期躁动的影响。方法选取本院收治的肱骨髁上骨折患儿72例，分为右美托咪定组和对照组，两组术前常规禁食、禁饮4 h。麻醉前10 min静脉注射咪达唑仑0.1 mg/kg，盐酸戊乙奎醚0.01 mg/kg；常规监测BP、RR、HR、SpO2，并检测脑电双频谱指数(BIS)；然后进行麻醉诱导，麻醉诱导成功后行气管插管，并连接呼吸机，采用PCV模式行机械通气。右美托咪定组在麻醉诱导前10 min静脉输注右美托咪定，对照组予以等容量生理盐水。两组给药结束后即可开始手法复位，两组患儿术中吸入2%~4%七氟醚以维持麻醉，BIS值保持在45~60。观察两组患儿手法复位时间、拔管时间、麻醉时间、苏醒时间、七氟醚用量、呼气末七氟醚浓度、躁动发生率、苏醒期评分以及两组患儿不同时点血糖和血清皮质醇浓度。结果与对照组比较，右美托咪定组拔管时间、苏醒时间明显缩短，七氟醚用量减少，呼气末七氟醚浓度、躁动发生率、血糖和血清皮质醇浓度以及苏醒期评分明显降低，差异有统计学意义(P<0.05)。结论右美托咪定对肱骨髁上骨折患儿手法复位术后七氟醚麻醉苏醒期躁动可产生可靠的麻醉效应，且未发生不良反应，值得推广应用。
目的：探討右美託咪定對肱骨髁上骨摺患兒手法複位術後七氟醚痳醉囌醒期躁動的影響。方法選取本院收治的肱骨髁上骨摺患兒72例，分為右美託咪定組和對照組，兩組術前常規禁食、禁飲4 h。痳醉前10 min靜脈註射咪達唑崙0.1 mg/kg，鹽痠戊乙奎醚0.01 mg/kg；常規鑑測BP、RR、HR、SpO2，併檢測腦電雙頻譜指數(BIS)；然後進行痳醉誘導，痳醉誘導成功後行氣管插管，併連接呼吸機，採用PCV模式行機械通氣。右美託咪定組在痳醉誘導前10 min靜脈輸註右美託咪定，對照組予以等容量生理鹽水。兩組給藥結束後即可開始手法複位，兩組患兒術中吸入2%~4%七氟醚以維持痳醉，BIS值保持在45~60。觀察兩組患兒手法複位時間、拔管時間、痳醉時間、囌醒時間、七氟醚用量、呼氣末七氟醚濃度、躁動髮生率、囌醒期評分以及兩組患兒不同時點血糖和血清皮質醇濃度。結果與對照組比較，右美託咪定組拔管時間、囌醒時間明顯縮短，七氟醚用量減少，呼氣末七氟醚濃度、躁動髮生率、血糖和血清皮質醇濃度以及囌醒期評分明顯降低，差異有統計學意義(P<0.05)。結論右美託咪定對肱骨髁上骨摺患兒手法複位術後七氟醚痳醉囌醒期躁動可產生可靠的痳醉效應，且未髮生不良反應，值得推廣應用。
목적：탐토우미탁미정대굉골과상골절환인수법복위술후칠불미마취소성기조동적영향。방법선취본원수치적굉골과상골절환인72례，분위우미탁미정조화대조조，량조술전상규금식、금음4 h。마취전10 min정맥주사미체서륜0.1 mg/kg，염산무을규미0.01 mg/kg；상규감측BP、RR、HR、SpO2，병검측뇌전쌍빈보지수(BIS)；연후진행마취유도，마취유도성공후행기관삽관，병련접호흡궤，채용PCV모식행궤계통기。우미탁미정조재마취유도전10 min정맥수주우미탁미정，대조조여이등용량생리염수。량조급약결속후즉가개시수법복위，량조환인술중흡입2%~4%칠불미이유지마취，BIS치보지재45~60。관찰량조환인수법복위시간、발관시간、마취시간、소성시간、칠불미용량、호기말칠불미농도、조동발생솔、소성기평분이급량조환인불동시점혈당화혈청피질순농도。결과여대조조비교，우미탁미정조발관시간、소성시간명현축단，칠불미용량감소，호기말칠불미농도、조동발생솔、혈당화혈청피질순농도이급소성기평분명현강저，차이유통계학의의(P<0.05)。결론우미탁미정대굉골과상골절환인수법복위술후칠불미마취소성기조동가산생가고적마취효응，차미발생불량반응，치득추엄응용。
Objective To investigate the effect of dexmedetomidine on restlessness during sevoflurane anesthesia recov-ery period after operation of manipulative reduction in children with supracondylar fracture. Methods 72 children with supracondylar fracture were selected and divided into dexmedetomidine group and control group.Routine preoperative forbidden to fast and forbidden to drink 4 hours were used in two groups.Before anesthesia of 10 min,intravenous mida-zolam 0.1 mg/kg and penehyclidine hydrochloride 0.01 mg/kg were applied.Routine BP,RR,HR,SpO2 were monitored and bispectral index(BIS)was detected.Anesthesia was induced successfully underwent endotracheal intubation,and con-nected to a respirator,PCV mode mechanical ventilation was used.Before induction anesthesia of 10 min,intravenous in-fusion dexmedetomidine was used in dexmedetomidine group,the same volume of saline was applied in control group. Manipulative reduction was applied after the end of dosing.Two groups of children intraoperative inhaled 2%-4%sevoflurane to maintain anesthesia.BIS value was maintained at 45 to 60.Practice reset time,extubation time,anesthesia time, ecovery time,the amount of gas isoflurane,end-tidal sevoflurane concentration,incidence rate of restlessness,recov-ery period score,different points glucose and serum cortisol concentration were observed. Results Compared with control group,extubation time,recovery time in dexmedetomidine group was significantly shorter respectively (P<0.05).Compared with control group,the isoflurane gas consumption,end-tidal sevoflurane concentration,incidence rate of restlessness,glu-cose and serum cortisol concentration,recovery period score was significantly lower respectively,with statistical differ-ence(P<0.05). Conclusion Dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after opera-tion of manipulative reduction in children with supracondylar fracture has reliable anesthetic effect,has no produce ad-verse reaction.So it is worthy of promotion and application.
