摘要
目的观察比较在小儿腹腔镜阑尾切除手术中应用右美托咪定对麻醉深度和术后恢复的影响。方法选择ASA分级Ⅰ~Ⅱ级、年龄2~7岁、择期行腹腔镜阑尾切除手术患儿40例,随机分为右美托咪定组(D组)和对照组(C组),每组20例,在BIS监测下,D组患儿麻醉前15min给予右美托咪定0.3μg/kg缓慢静滴维持,C组患儿给予生理盐水缓慢静滴15min。记录两组患儿用药前(T0)、用药后(T1)、气管插管即刻(T2)、切皮(T3)、术中15min(T4)、手术结束(T5)时的平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)值和术后苏醒时间、疼痛视觉模拟评分(VAS)及躁动发生率等。结果与T。时比较,T厂E时D组患者MAP、HR、BIS值明显降低(P<0.05);T,~T5时D组较C组具有更低的MAP、HR和BIS值(P<0.05);D组术后VAS评分及恶心、呕吐、躁动发生率明显低于C组(P<0.05)。结论在小儿腹腔镜阑尾切除手术中预应用右美托咪定,结合BIS监测,能获得更佳的麻醉深度,减少血流动力学指标波动,术后苏醒及时,疼痛减轻,并发症减少。
Objective To observe and compare the effect of dexmedetomidine on the depth of anesthesia and recovery after laparoscopic appendectomy in children.Methods 40 children aged 2 to 7 years with ASA gradingⅠ~Ⅱ were selected for laparoscopic appendectomy. They were randomly divided into dexmedetomidine group (group D) and control group (group C), 20 cases in each group. Under BIS monitoring, children in group D were given dexmedetomidine 15 minutes before anesthesia, 0.3 μg/kg was maintained by slow intravenous drip, while those in group C were given normal saline 15 minutes after intravenous drip. AMP, HR, BIS and recovery time, VAS of pain and incidence of agitation were recorded before medication (T0), after medication (T1), immediately after tracheal intubation (T2), skin incision (T3), 15 minutes during operation (T4) and at the end of operation (T5). Results Compared with To, MAP, HR and BIS decrease obviously(P<0.05) at T1~T5 time point in group D;Compare with group C, there are patency lower MAP, HR and BIS at T1~T5 time point in group D (P<0.05);VAS Score and agitated incidence are also lower after surgery in group D than in group C(P<0.05). Conclusion Pre-intravenous injection dexmedetomidine before general anesthesia of pedo-laparoscopic appendectomy operation, combination with BIS, could reduce haemodynamics fluctuation , postoperative pain and post-surgery complication , acquire better depth of anesthesia and palinesthesia time.
作者
蔡军
于刚
颜建娥
侍海碧
秦晗
CAI Jun;YU Gang;YAN Jian-e;SHI Hai-bi;QIN Han(the first author,Department of Anesthesiology,Maternal and Ch辻d Health hospital of Lianyungang City,Lianyun-gang 222006,China)
出处
《中国急救复苏与灾害医学杂志》
2019年第9期857-860,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省妇幼健康科研项目(F201859).
关键词
右美托咪定
麻醉
小儿腹腔镜阑尾切除术
脑电双频指数
sdexmedetomidine
aesthesia
pedo-laparoscopic appendectomy operation
bispectral index
