| 姚菊,黄赛赛.不同剂量右美托咪啶用于小儿腹腔镜手术的临床研究[J].安徽医药,2016,20(12):2343-2346. |
| 不同剂量右美托咪啶用于小儿腹腔镜手术的临床研究 |
| Effects of different doses of dexmedetomidine in children undergoing laparoscopic surgery |
| 投稿时间：2016-06-21 |
| DOI： |
| 中文关键词: 右美托咪啶 儿童 腹腔镜 |
| 英文关键词: Dexmedetomidine Children Laparoscope |
| 基金项目: |
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| 摘要点击次数: 2456 |
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| 中文摘要: |
| 目的 研究三种剂量右美托咪啶用于小儿腹腔镜手术中的麻醉效果及安全性。方法 择期行腹腔镜手术的患儿 80例,按简单随机法分为4组,每组20例。对照组(C组)患儿插管后静脉泵推注生理盐水0.1 mL·kg-1·h-1,低、中、高剂量右美托咪啶组(D1、D2、D3组)患儿插管后分别用静脉泵推注右美托咪啶0.2、0.5、0.7 μg·kg-1·h-1。记录患儿入室时(T1)、麻醉诱导后(T2) 、手术开始10 min(T3)、术毕(T4)的平均动脉压(MAP)、心率(HR) ;苏醒时间,拔管时间、麻醉后监测治疗室(PACU)停留时间;苏醒期疼痛评分;术后躁动发生例数、比例;术后患儿呼吸抑制、心动过缓、恶心、呕吐等不良反应发生率。结果 T3、T4时间点D1、D2、D3组患儿HR显著低于T1(F=23.271、9.665、56.383、11.322、10.334、6.981,P<0.05),也显著低于同一时间点C组患儿(F=55.620、23.563,P<0.05),四组患儿T2时间点MAP均显著低于T1(F=23.555、36.448、53.156、10.878,P<0.05)；术后疼痛评分D1、D2、D3组显著低于对照组(F=2.623,P<0.05),而D3组又明显低于D1和D2组(F=9.783,P<0.05)；苏醒期躁动发生率D1、D2、D3组显著低于对照组(χ2=10.435,P<0.05),而D3组又明显低于D1和D2组(χ2=2.332,P<0.05)。四组患儿均未有呼吸抑制和心动过缓。C组有1例患儿发生恶心呕吐。结论 0.7 μg·kg-1·h-1右美托咪啶静脉泵注用于小儿腹腔镜手术,血流动力学平稳,镇痛效果好,减少苏醒期躁动发生率,不良反应少,更适用于临床。 |
| 英文摘要: |
| Objective To evaluate the effectiveness and safety of different doses of dexmedetomidine infusion in children undergoing laparoscopic surgery during general anesthesia.Methods Eighty children scheduled for laparoscopic surgery were randomized into four groups (n=20 each).After general anesthesia induction children in group D1,D2,D3 were intravenously infused with 0.2,0.5,0.7 μg·kg-1·h-1 dexmedetomidine respectively while children in group Cwere intravenously infused with the same volume of normal saline.Mean arterial pressure(MAP) and heart rate(HR) at the time before anesthesia(T1),completion of induction of general anesthesia(T2),10 min after operation(T3) and completion of operation(T4) were recorded.The recovery time,extubation time,PACU indwelling time,postoperative pain score,recovery agitation score and the incidence of emergence agitation were documented.The side effects including respiratory depression,bradycardia,nausea and vomiting were also recorded.Results The HR in group D1,D2 and D3 at the time of T3 and T4 were lower than that at the time of T1(F=23.271,9.665,6.383,1.322,0.334,6.981,P<0.05)and also lower than that in group C(F=55.620,3.563,P<0.05).The MAP in all four groups at T2 were lower than that at T1(F=23.555,36.448,3.156,0.878,P<0.05).The recovery time,extubation time and the PACU indwelling time were similar among all four groups (P>0.05).Postoperative pain score was lower in group D1,D2,D3 than that in group C(F=2.623,P<0.05)while postoperative pain score in group D3 was lower than that in group D1 and D2(F=9.783,P<0.05).The incidence of emergence agitation was lower in group D1,D2,D3 than that in group C(χ2=10.435,P<0.05)while that in group D3 was lower than that in group D1 and D2(χ2=2.332,P<0.05).There was no significance in side effects among four groups.Conclusions Intravenous infusion of 0.7 μg·kg-1·h-1 dexmedetomidine after tracheal intubation can effectively reduce the postoperative pain score and the incidence of emergence agitation in children undergoing laparoscopic surgery and is more suitable for clinical application. |
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