摘要
目的探讨盐酸右美托咪定在小儿骶麻镇静中的临床价值。方法将85例择期行一次性根治术的肛周脓肿患儿分为两组,全部患儿均采用骶管麻醉,研究组采用盐酸右美托咪定辅助镇静,对照组采用丙泊酚辅助镇静,对比两组患儿在T0（桡动脉穿刺成功时）、T1（切皮时）、T2（探查内口时）、T3（切除病灶时）的心率（HR）、动脉压（MAP）、脑电双频谱指数（BIS值）、血糖、血清皮质醇（COR）、肾上腺素（E）的水平变化,观察并记录两组患儿苏醒时间及呼吸抑制、术后躁动发生情况。结果两组在各时间点BIS值对比差异无统计学意义（P〉0.05）;在T2和T3时,研究组HR、MAP水平显著低于对照组,差异有统计学意义（t=4.145、4.216、4.576、4.350,P〈0.05）;在T1、T2、T3时,研究组COR、E水平均低于对照组,差异有统计学意义（t=3.596、3.531、3.887、4.748、4.334、4.767,P〈0.05）;对照组术中COR、E水平明显升高,差异有统计学意义（F=4.337、5.120,P〈0.05）;研究组术后苏醒时间高于对照组,差异有统计学意义（t=11.068,P〈0.05）;研究组出现呼吸抑制、术后躁动的发生率低于对照组,差异有统计学意义（χ^2=5.439、6.609,P〈0.05）。结论盐酸右美托咪定用于小儿肛周脓肿一次性根治术骶管麻醉辅助镇静,能有效减轻应激反应,降低呼吸抑制及术后躁动的发生。
Objective To investigate the clinical value of dexmedetomidine hydrochloride in sacral anesthesia and sedation in children.Methods A total of 85 cases were assigned into two groups of children with anal abscess undergoing elective radical operation. Sacral anesthesia was used in all patients. Dexmedetomidine sedation was used in the study group while in the control group,propofol was used to assist sedation. Changes in heart rate,arterial pressure,brain electrical double spectrum index,blood glucose,serum cortisol and adrenaline were compared between the two groups of children in T0,T1,T2,T3. The recovery time of two groups of children and the incidence of respiratory depression and postoperative restlessness were also observed and recorded. Results There was no significant difference between the two groups at each time point BIS（ P〈0. 05）. At T2 and T3,the levels of MAP and HR in the study group were significantly lower than those in the control group（ t = 4. 145,4. 216,4. 576,4. 350,P〈0. 05）. At T1,T2 and T3,COR and E in the study group were significantly lower than those in the control group（ t = 3. 596,3. 531,3. 887,4. 748,4. 334,4. 767,P〈0. 05）. In the control group,the levels of E and COR were significantly increased（ F = 4. 337,5. 120,P〈0. 05）. The recovery time of the study group was significantly higher than that of the control group（ t = 11. 068,P〈0. 05）. The incidence of respiratory depression and agitation in the study group was significantly lower than that in the control group（ x^2= 5. 439,6.609,P〈0. 05）. Conclusions Dexmedetomidine hydrochloride used for sacral anesthesia and sedation in children undergoing radical resection for anal abscess can effectively alleviate the stress response and reduce the incidence of respiratory depression and postoperative restlessness.
出处
《安徽医药》
CAS
2016年第7期1388-1391,共4页
Anhui Medical and Pharmaceutical Journal
关键词
麻醉
脊尾
右美托咪啶/治疗应用
儿童
Anesthesia
Caudal
Dexmedetomidine / therapeutic use
Child
