右美托咪定预防小儿七氟烷麻醉后苏醒期的躁动反应.pdf

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1、医学』临床研究2013年11月第3O卷第11期JClinRes，Nov．2013，Vol30，Nol1·论著·右美托咪定预防小儿七氟烷麻醉后苏醒期的躁动反应张志军张永平(河南省安阳市人民医院麻醉科，河南安阳455000)[摘要]【目的】探讨右关托咪定对小儿七氟烷麻醉后苏醒期躁动的预防作用。【方法】本院8O例急诊手术患儿，按实验设计分成右美托咪定组(A组)和对照组(B组)，每组4O例。两组患儿均采用七氟烷吸入诱导，气管插管后行机械通气，术中予吸入七氟烷一空氧混合气体维持。A组在此基础上连续静脉输注右美托咪定O．5g／(kg·h)至手术结

2、束前5rain停用。采用改良Aldrete评分、PAEDS评分和CHE0PS评分对两组患儿的复苏状况、苏醒期躁动和术后疼痛进行评估。【结果】两组患儿麻醉后恢复室(PACu)停留时间相比较差异无显著性(P>O．05)，A组苏醒期各时间段躁动发生率均小于B组(Pd0．05)。两组患儿各时段改良Aldrete评分比较无统计学差异。入PACU后B组各时点PAEDS评分均高于A组(P<0．05)，且第20min和第30minB组CHEOPS评分高于A组(P<0．05)。【结论】静脉连续输注右美托咪定不会显著延长小儿的苏醒时间，且苏醒过程中躁动的

3、发生率明显降低，因此右美托咪定能预防小儿七氟烷麻醉后苏醒期的躁动反应。[关键词]右美托咪啶；麻醉DexmedetomidineforPreventingtheAgitationafterSevofluraneAnesthesiainPediatricPatientsDuringWakefulnessZHANGZhi—jan，ZHANGYong-ping(DepartmentofAnesthesiology。8People'sHospitalofAnyangCity，Henan455000，China)[Abstract][Object

4、ive]Toexploredexmedetomidineforpreventingtheagitationaftersevofluraneanesthesiainchil—drenduringwakefulness．[Methods]Accordingtoexperimentaldesign，80pediatricpatientswithemergencyoperationinourhospitalwererandomlyassignedintodexmedetomidinegroup(GroupA)andcontrolgroup(G

5、roupB)with40casesineachgroup．Pediatricpatientsinbothgroupsweregivenmechanicalventilationaftertrachealintubationundersevofluraneinductioninhalation，andtheninhaledwithsevofluraneandoxygen-airmixedgasforanesthesiamaintenance．Additional—lY，GroupAreceivedcontinuousintravenou

6、sinfusionwithdexmedetomidine0．5fg／kg／hruntil5minbeforetheendofsurgery．ThemodifiedAldretescale，PAEDSscoreandCHE0PSscorewereusedtoevaluatetheresuscitationstate，agi—tationduringwakefulnessandpostoperativepain．[Results]Therewasnosignificantdifferenceofstaytimeinpostanes—the

7、ticrecoveryroom(PACU)betweentwogroup(P>O．05)．TheincidenceofagitationinGroupAateachperiodduringwakefulnessW3SlowerthanthatinGroupB(Pd0．05)．TherewasnosignificantdifferenceinmodifiedAldretescoreateachperiodbetweentWOgroups．PAEDSscoreofGroupBinPACUateachtimepointwashigherth

8、anthatofGroupA(Pd0．05)，andCHEOPSscoresofGroupBat20minand30minwerehigherthanthoseofGroupA(Pd0．05)．[Con—clusion]