右美托咪定在小儿全身麻醉苏醒期躁动防治中的应用.pdf

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1、·680·ShanghaiMedJ，2013，Vo1．36，No．8●／J、L麻醉●右美托咪定在小儿全身麻醉苏醒期躁动防治中的应用郭云秀马柯王英伟【摘要】目的评价右美托咪定在4,JL全身麻醉苏醒期躁动防治中的应用价值。方法将120例择期行骨科手术的患儿随机分人右美托咪定0．4／~g／kg组、右美托咪定0．2>g／kg组、丙泊酚1n／kg组、o．9％氯化钠溶液组，每组3O例。右美托咪定0．4~g／kg组、右美托咪定0．2gg／kg组和0．9氯化钠溶液组分别于手术结束前经静脉输液泵注射相应药物10min，丙泊酚1m~／kg组于手术结束时经静脉输液泵注射丙泊酚。4组的药物容积均为

2、1OmL。4,JL苏醒期躁动评分采用Aono的四分评级法和儿童麻醉苏醒谵妄(PAED)评分，记录拔除气管导管后15min时的Aono评分、PAED评分和躁动发生率。结果右美托咪定0．4／kg组的Aono评分、PAED评分、躁动发生率均显著低于右美托咪定0．2,g／kg组、丙泊酚1m~／kg组和0．9氯化钠溶液组(P值均O．05)。所有患儿在麻醉诱导和维持中均无呕吐、误吸、呼吸暂停和喉痉挛等不良反应发生。结论手术结束前10min给予右美托咪定0．4~g／kg能够降低&JL苏醒期的术后躁动率。【关键词】右美托眯啶；苏醒期躁动

3、；丙}自酚；小儿ApplicationofdexmedetomidineforthepreventionofemergenceagitationinchiIdrenaftergeneralanesthesiaGUOYunxiu，MAKe，WANGYingwei．DepartmentofAnesthesiology，XinhuaHospitalChongmingBranch，ShanghaiJiaotongUniversitySchoolofMedicine，Shanghai202150，ChinaCorrespondingauthor：MAKeE-mail：marke72@

4、163．com[Abstract]ObjectiveToevaluatetheefectofdexmedetomidine(Dex)onemergenceagitationinchildrenaftergeneralanesthesia．MethodsAtotalof120pediatricpatientsundergoingelectiveorthopedicoperationwererandomlydividedintofourgroups(n30)Dex04pg／kg，Dex0．2pg／kgand0．9％sodiumchloridesolutionwerecontin

5、uouslyinfusedbyvenouspumpfor10minbeforetheendofthesurgery．Propofol1mg／kgwasbolusintravenouslyaftertheendofthesurgery．Thedrugsweredilutedto10mLnormalsaline．Aono’SFourPointScaleandPediatricAnesthesiaEmergenceDelirium(PAED)Scalewereusedtoevaluatetheemergenceagitation．Aonoscores，PAEDscoresandt

6、heincidenceofagitationwererecorded15minafterextubation．ResultsAonoscores，PAEDscoresandtheincidenceofagitationinDex0．4pg／kggroupweresignificantlylowerthanthoseinDex0．2pg／kggroup，propofol1mg／kggroupandsalinegroup(allP

7、kggroupandsalinegroup(allP>0．05)．Noadversereactionssuchasvomiting，aspiration，apneaorlaryngospasmoccurredinallchildrenduringtheinductionandmaintenanceofanesthesiaConclusionTheadministrationofDex0．4~g／kgat10minbeforetheendofoperationcandecreasetheincidenceofemer