目的 探討右美托咪定對小兒七氟烷吸入麻醉蘇醒期躁動的影響。 方法 選擇2011年3月-2012年1月美國麻醉醫(yī)師協(xié)會分級Ⅰ~Ⅱ級、年齡2~8歲、擇期行疝囊高位結(jié)扎術(shù)和隱睪下降固定術(shù)患兒40例,隨機(jī)分為2組,右美托咪定組(A組)和對照組(B組),兩組患兒在年齡、體重、手術(shù)種類無明顯差異。兩組患兒均采用面罩8%七氟烷吸入麻醉誘導(dǎo),開放靜脈,給予鹽酸戊乙奎醚0.1 mg/kg、順式阿曲庫銨0.15 mg/kg,插入喉罩,麻醉維持根據(jù)血壓、心率及腦電雙頻指數(shù)調(diào)節(jié)吸入麻醉藥濃度。A組靜脈給予1 μg/kg右美托咪定,B組給予同等容量的生理鹽水。入室至手術(shù)結(jié)束時連續(xù)觀察收縮壓、舒張壓、心率、血氧飽和度,記錄清醒時間、拔除喉罩時間,記錄蘇醒期并發(fā)癥的發(fā)生數(shù)。記錄入麻醉恢復(fù)室即刻(0 min)、15、30、60、90 min患兒疼痛和躁動評分。 結(jié)果 兩組患兒在手術(shù)時間、清醒時間以及拔除喉罩時間差異無統(tǒng)計(jì)學(xué)意義(P>0.05),A組術(shù)后入恢復(fù)室0、15、30 min疼痛評分和躁動評分均低于B組(P<0.05),兩組患兒圍術(shù)期均未出現(xiàn)低血壓和心動過緩。 結(jié)論 右美托咪定用于小兒七氟烷吸入麻醉能夠增強(qiáng)術(shù)后鎮(zhèn)痛,減少蘇醒期躁動。
引用本文: 趙艷玲,王光磊. 右美托咪定對小兒七氟烷吸入麻醉蘇醒期躁動的影響. 華西醫(yī)學(xué), 2012, 27(9): 1366-1368. doi: 復(fù)制
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- 1. Sikich N, Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale[J]. Anesthesiology, 2004, 100(5): 1138-1145.
- 2. Cole JW, Murray DJ, Mcallister JD, et al. Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia[J]. Paediatr Anaesth, 2002, 12(5): 442-447.
- 3. Weldon BC, Bell M, Craddock T. The effect of caudal analgesia on emergence agitation in children after sevoflurane versus halothane anesthesia[J]. Anesth Analg, 2004, 98(2): 321-326.
- 4. 郭繼龍, 張聯(lián)義, 王光磊, 等. 腹股溝斜疝修補(bǔ)術(shù)的臨床觀察[J]. 徐州醫(yī)學(xué)院學(xué)報(bào), 2008, 28(1): 746-748.
- 5. Veyckemans F. Excitation phenomena during sevoflurane anaesthesia in children[J]. Curr Opin Anaesthesiol, 2001, 14(3): 339-343.
- 6. Okamoto T, Mori T, Takeda T, et al. Dexmedetomidine is an excellent sedative for voice monitoring surgery[J]. Masui, 2012, 61(5): 542-554.
- 7. Bajwa SJ, Kaur J, Singh A, et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine[J]. Indian J Anaesth, 2012, 56(2): 123-128.
- 8. Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials[J]. Anesthesiology, 2012, 116(6): 1312-1322.
- 9. Santos LC, Ludders JW, Erb HN, et al. A randomized, blinded, controlled trial of the antiemetic effect of ondansetron on dexmedetomidine-induced emesis in cats[J]. Vet Anaesth Analg, 2011, 38(4): 320-327.
- 10. Massad IM, Mohsen WA, Basha AS, et al. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery[J]. Saudi Med J, 2009, 30(12): 1537-1541.
- 11. Mizrak A, Erbagci I, Arici T, et al. Dexmedetomidine use during strabismus surgery in agitated children[J]. Med Princ Pract, 2011, 20(5): 427-432.
- 12. Ozcengiz D, Gunes Y, Melatonin O. Dexmedetomidine and midazolam for prevention of postoperative agitation in children[J]. J Anesth, 2011, 25(2): 184-188.
- 13. Isik B, Arslan M, Tunga AD, et al. Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery[J]. Paediatr Anaesth, 2006, 16(7): 748-753.
- 14. Saadawy I, Boker A, Elshahawy MA, et al. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics[J]. Acta Anaesthesiol Scand, 2009, 53(2): 251-256.