右美托咪啶与丙泊酚用于小儿心导管术麻醉维持的比较

目的 右美托咪啶(dexmedetomidine,DEX)为α2肾上腺素受体激动剂,目前较多研究正在探索其用于小儿麻醉的可行性.研究比较了DEX与丙泊酚用于小儿心导管术的维持麻醉的药效学.方法 选择40例ASA Ⅱ～Ⅲ级、22月～67月、体重11 kg～28 kg导管介入治疗患儿,进入导管室后静注氯胺酮2 mg/kg,...

Comparison of dexmedetomidine with propofol for maintenance of anesthesia undergoing cardiac catbeterization in children

Objective Dexmedetomidine(DEX) is α2 agonist currently being investigated for its application in anesthesia for children. Pharmacodynamic responses to DEX and propofol in children anesthetized undergoing cardiac catheterization were compared. Methods Forty children( 22 kg～67 kg months old, 11 kg～28 kg) were randomized to receive either propofol (group P) or DEX (group D) for anesthesia maintenance for elective cardiac catheterization. All patients received ketamine 2 mg/kg, midazolam 0.1 mg/kg and penehyclidine hydrochloride 0.05 mg/kg intravenously after arriving at the cardiac catheterization room. DEX was administered at an initial loading dose (0.8 g/kg for 10 min) followed by a continuous infusion (1 μg·kg-1·h-1) in group D. Propofol was administered at a bolus dose (1.5 mg·kg-1h-1 for 10 min) followed by a continuous infusion(3 mg·kg-1·h-1). The infusion rates of DEX or propofol were adjusted to maintain BIS 55 to 65 during the operation. Vital signs, PETCO2 and supplemental sedatives were monitored and documented. Results Heart rate was significantly slower in group D (117±10) bpm than in group P (126±9) bpm 40 min after DEX or propofol administration (P<0.05). There was no significant difference in PETCO2 between two groups. Requirement of supplemental sedatives was less in group D than in group P (12 cases) (P<0.05). Conclusion DEX provides adequate anesthesia for cardiac catheterization. Compared with propofol, DEX led to lower heart rate and less agitation after catheterization.