摘要
目的:探讨是否持续静脉泵注右美托咪啶能够减少小儿腭裂修补手术全麻后恢复期躁动的发生。方法:选取择期行唇腭裂检查的患儿60例,随机分为右美托咪定组(D组)和生理盐水组(C组),D组于全麻诱导后给于持续泵注右美托咪啶(0.6μg/kg min),C组则给与相同体积的生理盐水。两组的诱导方法相同:芬太尼0.005 mg/kg,异丙酚2mg/kg,维库溴铵0.2 mg/kg,麻醉维持主要是泵注瑞芬太尼0.1μg/kg·h及吸入2%-3%的七氟醚。记录患者在手术开始时刻(T1),手术后15 min(T2),30 min(T3)和拔管时刻(T4)的生命体征,记录患者呼吸恢复时间和拔管时间,术后躁动情况,使用躁动行为评分表,对记录的数据进行组间比较,计量资料采用x±s,采用t检验,计数资料采用X^2检验。结果:C组患者的心率在手术开始时刻(T1),手术后15 min(T2),30 min(T3)和拔管时刻(T4)明显高于D组(P<0.05);C组平均动脉压在各个时刻明显高于D组;D组的躁动评分明显的低于C组(P<0.05),D组的躁动发生率是20%,C组的发生率是80%(P<0.05)。结论:右美托咪啶持续泵注下行小儿腭裂修补对循环影响较小,可以显著地降低全麻后患儿的躁动发生率。
Objective： To observe whether pumping dexmedetomidine can effect the incidence of emergence agitation after general anesthesia in infant who received cleft palate repair surgery. Methods： 60 children who would be performed for cleft palate repair surgery were randomly divided into two groups, dexrnedetomidine- remifentanil group （groupD, n=30） and control group （group C, n=30）. The patients in group D received continuous infusion of dexmedetomidine （0.6 μg/kg·min） after intubation. The patients of another group were administered with infusion of the equivalent volume of normal saline. Two groups were induced as follows： fentanyl 0.005 mg/kg, propofol 2 mg/kg and cisatracufium 0.2 mg/kg. Anesthesia was maintained with remifentanil （0.1 μg/kg·h） and inhalation of 2 %-3 % sevoflurane. HR, MAP, SPO_2 in different time （T1, T2, T3, T4） were recorded during anthesia. Breathing recovery time and extuhation time were also recored. Agitation score was used to evaluate postoperative agitation.Data were compared between groups. Data processing and statistical analysis using SPSS13.0 statistical analysis package, the measurement data used t-test, counting card information using the X^2 test. Results： The heart rate in group C was significant higher than that in group D at the beginning time of operation, postoperative 15 min, 30 rain and the extubation time （P〈0.05）. MAP of group C was higher than that in group D at the time of extubation （P〈0.05）. The incidence of emergence agitation in group D and C was 80 % and 20 % （P〈0.05）. Conclusions： Dexmedetomidine could be used safely and effectively in intravenous pumping of infant undergoing cleft palate repair surgery, for little effect on the circulation, decreasing emergence agitation.
出处
《现代生物医学进展》
CAS
2016年第20期3936-3938,3956,共4页
Progress in Modern Biomedicine
基金
国家自然科学基金项目(81072888)
关键词
右美托咪啶
全身麻醉
腭裂修复手术
静脉输注
Dexmedetomidine
General anesthesia
Cleft palate repair surgery
Intravenous infusion
