右美托咪啶在小儿全麻诱导中对循环、呼吸的影响

【目的】评价右美托咪啶在小儿诱导中的镇静效应及其对循环和呼吸的影响。【方法】60例行扁桃体和（或）腺样体择期手术患儿,随机分为3组,每组20例。诱导开始后分别在10min内给予右美托咪啶1μg／kg（D1组）、右美托咪啶0．5μg／kg（D2组）和咪唑安定0．2mg／kg（M组）静脉泵注,随后再静注芬太尼、赛肌宁行气管插管。记录诱导前（T0）、诱导开始后5min（T1）、10min（T2）、插管前（T3）、插管后即刻（T4）的Ramsay评分、脑电双频指数（BIS）、心率（HR）、收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）、脉搏血氧饱和度（SpO2）、呼吸频率（RR）。【结果】三组T1、T2时点Ramsay评分值均较T0显著增加（P〈0．05）,组间比较三组Ramsay评分值有统计学差异,D1〉D2〉M。D1和D2组T1～3时点HR、SBP均较T0时下降（P〈0．05）。组间比较M组T1、T2时点的HR高于D1、D2组。【结论】右美托咪啶1μg／kg在小儿全麻诱导中可提供良好的镇静效应,并能维持血流动力学平稳。

Effect of Dexmedetomidine on the Circulation and Respiration in Children During General Anesthesia Induction

[Objective] To evaluate the sedative effect of dexmedetomidine and its effect on the circulation and respiration in children during induction. [Methods] Sixty children undergoing elective tonsillectomy or adenoidectomy were randomly divided into 3 groups with 20 cases for each. They received intravenous dexme-detomidine 1 μg/kg （group D1 ）, dexmedetomidine 0.5/μg/kg（group D2） and midazolam 0.2 mg/kg（grbup M） in 10min after induction, respectively. Then tracheal intubation was performed after fentanyl and cisatracurium administered intravenously. The Ramsay sedation score, bispectral index （BIS）, heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial blood pressure （MBP）, peripheral oxygen saturation （SpO2） and respiratory rate （RR） were monitored and recorded at time before dexmedetomidine infusion （T0）, 5min after infusion（T1 ）, 10min after infusion（T2 ）, before intubation（T3 ） and after intubation （T4）. [Results] The Ramsay sedation score at T1 and T2 increased more significantly than that at To in all three groups（ P〈0.05）, and there was significant difference among three groups （D1〉 D2〉M）. As compared at To, the baseline value （T0）, HR and SBP at T1-3 in group DI and D2 decreased significantly（ P〈0.05）. HR at TI and T2 in group M was significantly higher than that in group Dl and D2. [Conclusion] Dexmedetomidine 1 μg/kg during general anesthesia induction can provide good sedative effect and maintain stable hemodynamics for children.