CAJ | 학술논문

目的：观察经鼻滴入右美托咪定预防儿童全身麻醉苏醒期躁动的临床效果。方法选ASA分级I~Ⅱ级、在丙泊酚瑞芬太尼复合七氟醚静吸复合麻醉下行发育性髋关节脱位矫正术的12~14岁患儿60例。随机分为对照组和右美托咪定组各30例。在手术结束前30 min右美托咪定组给予1μg/kg右美托咪定滴鼻，对照组给予生理盐水0.01 ml/kg滴鼻。记录患儿苏醒即刻（ T0）、苏醒5 min后（ T1）、苏醒10 min后（ T2）、苏醒30 min后（ T3）的心率（ HR），以及拔管3 min（ T4）、拔管5 min（ T5）、拔管10 min（ T6）的血氧饱和度（ SpO2）以及拔管10 min时Aono躁动评分和儿童麻醉苏醒谵妄PAED评分及躁动发生率。结果右美托咪定组Aono评分、PAED评分及躁动发生率均显著低于对照组（ P ﹤0.05）。两组患儿苏醒时各时间点SpO2、HR均无统计学差异（ P ﹥0.05）。所有患儿在麻醉手术过程中均无呕吐、喉痉挛、误吸等不良反应发生。结论手术结束前30 min经鼻给予1μg/kg右美托咪定可以明显减少手术患儿全麻苏醒期躁动的发生，是临床上预防苏醒期躁动的一个行之有效且安全的给药方法。
목적：관찰경비적입우미탁미정예방인동전신마취소성기조동적림상효과。방법선ASA분급I~Ⅱ급、재병박분서분태니복합칠불미정흡복합마취하행발육성관관절탈위교정술적12~14세환인60례。수궤분위대조조화우미탁미정조각30례。재수술결속전30 min우미탁미정조급여1μg/kg우미탁미정적비，대조조급여생리염수0.01 ml/kg적비。기록환인소성즉각（ T0）、소성5 min후（ T1）、소성10 min후（ T2）、소성30 min후（ T3）적심솔（ HR），이급발관3 min（ T4）、발관5 min（ T5）、발관10 min（ T6）적혈양포화도（ SpO2）이급발관10 min시Aono조동평분화인동마취소성섬망PAED평분급조동발생솔。결과우미탁미정조Aono평분、PAED평분급조동발생솔균현저저우대조조（ P ﹤0.05）。량조환인소성시각시간점SpO2、HR균무통계학차이（ P ﹥0.05）。소유환인재마취수술과정중균무구토、후경련、오흡등불량반응발생。결론수술결속전30 min경비급여1μg/kg우미탁미정가이명현감소수술환인전마소성기조동적발생，시림상상예방소성기조동적일개행지유효차안전적급약방법。
Objective This study was designed to observe the use of intranasally administered dexmedetomidine( Dex)as an intraopera-tive dosing method on emergence agitation in children after general anesthesia. Methods Sixty children of American Society of Anesthesiology classification( ASA)physical status( I&II),aged 12-14 years,treating DDH under general anesthesia,were randomly assigned to one of two equal groups. Dex 1μg/kg and 0. 9% saline 0. 01 ml/kg was given by intranasally administered at 30 min before the end of surgery. Heart rate (HR)was observed and recorded at wake-up after anesthesia(T0),5 min after wake-up(T1),10 min after wake-up(T2),30 min after wake-up( T3 ),Oxygen saturatio( SpO2 )were also observed and recorded at 3 min after tracheal extubation( T4 ),5 min after tracheal extuba-tion(T5),10 min after tracheal extubation(T6). Aono scores,PAED scores and the incidence of agitation were also recorded 10 min after extu-bation. Results Aono scores,PAED scores and the incidence of agitation were significantly lower in group D compared group S( P ﹤0. 05). There was no obviously difference on HR MAP and SpO2 between two group of children( P ﹥0. 05). And no incidence of vomiting,laryngospasm and aspiration was observed in either of the group during the study. Conclusion Intranasal dexmedetomidine(1μg/kg)at 30 min before the end of surgery can reduce the incidence of emergence agitation in children and it is an effective and safe alternative for preventing emergence agitation.