| 汪卫兵,孙爱娇,徐煌,等.右美托咪定平均有效剂量及95% 有效剂量的测定对预防学龄前期儿童麻醉苏醒期躁动的意义[J].安徽医药,2022,26(5):1034-1038. |
| 右美托咪定平均有效剂量及95% 有效剂量的测定对预防学龄前期儿童麻醉苏醒期躁动的意义 |
| Determination of the median effective dose of dexmedetomidine for the prevention of agita?tion during anesthesia recovery in pre-school children |
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| DOI：10.3969/j.issn.1009-6469.2022.05.044 |
| 中文关键词: 右美托咪定 平均有效量 扁桃体切除术 全身麻醉 儿童，学龄前 |
| 英文关键词: Dexmedetomidine Median effective dose Tonsillectomy General anesthesia Child,preschool |
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| 中文摘要: |
| 目的探讨右美托咪定平均有效剂量(ED50)及95%有效剂量(ED95)测定对预防学龄前期儿童行扁桃体和(或)腺样体切除术麻醉苏醒期躁动的意义。方法选取2019年8―12月安庆市立医院拟在全身麻醉下行扁桃体和(或)腺样体切除术的学龄前期病儿60例，均为美国麻醉医师协会(ASA)Ⅰ～Ⅱ级，第一例病儿完成气管插管后，采用右美托咪定0.6 μg·kg-1·h-1持续静脉输注，直到手术结束停止输注。根据Dixon序贯法，若病儿发生苏醒期躁动则为无效剂量，则下一例病儿采用高一级剂量，若病儿未发生苏醒期躁动则为有效剂量，则下一例病儿采用低一级剂量，相邻剂量相差0.05 μg。儿童苏醒期躁动采用儿童术后躁动评分量表(PAED)，PAED≥12分定义为麻醉苏醒期躁动。结果根据Dixon-Massey公式计算，右美托咪定用于预防学龄前期儿童苏醒期躁动的ED50为0.41 μg·kg-1·h-1(95% CI:0.38~0.44)，利用Probit回归预测其ED95为0.57 μg·kg-1·h-1(95% CI:0.52~0.70)。所有病儿未发生镇静时间延长、呼吸抑制及拔管时间延迟等并发症，心动过缓是主要并发症。结论对于预防学龄前期儿童苏醒期躁动，合适的右美托咪定剂量非常重要。ED50和ED95测定能有效预防学龄前期儿童苏醒期躁动，而且未出现类似成人的并发症。 |
| 英文摘要: |
| Objective To determine the median effective dose (ED50) and 95% effective dose (ED95) of dexmedetomidine in pre?vention of the emergence agitation for pre-school children undergoing tonsillectomy and/or adenoidectomy with general anesthesia.Methods A total of 60 pre-school children (ASA Ⅰ to Ⅱ) scheduled for tonsillectomy and (or) adenoidectomy under general anesthe?sia in Anqing Municipal Hospital from August to December 2019 were enrolled. After the first children underwent tracheal intubation,dexmedetomidine 0.6 μg·kg-1·h-1 intravenous continuous infusion, and the infusion was stopped until end of the surgery. According to the Dixon up-and-down method, if the patient had resuscitation agitation, it was an invalid dose, and the next patient was given a higher first-order dose; if the patient did not have resuscitation agitation, it was an effective dose, and the next patient was given a lower firstorder dose with a difference of 0.05 μg between adjacent doses. Children's Postoperative Agitation Rating Scale (PAED) was used in Children's agitation during emergence from anesthesia, PAED≥12 points was defined as agitation during recovery from anesthesia.Re?sults The ED50 of dexmedetomidine in prevention of the emergence agitation for pre-school children undergoing tonsillectomy was calculated by Dixon-Massey formula was 0.41 μg·kg-1·h-1 (95%CI:0.38-0.44), and ED95 was calculated by Probit regression analysis was 0.57 μg·kg-1·h-1 (95%CI:0.52-0.70).Conclusion Dexmedetomidine can effectively prevent agitation during recovery period for pre-school children undergoing tonsillectomy and/or adenoidectomy, bradycardia is the main complication in perioperative period. |
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