右美托咪定复合布比卡因骶管阻滞对预防七氟醚 小儿麻醉苏醒期躁动的观察分析

目的 右美托咪定复合布比卡因骶管阻滞预防小儿七氟醚麻醉术后苏醒期躁动的效果。方法 选择2~6岁择期行疝、鞘膜积液、尿道下裂，隐睾手术治疗的患儿60例。所有患儿均为ASA1级，均行骶管阻滞，随机分为两组，每组30例，B-D组行0.25%布比卡因复合1.5 μg/kg右美托咪定骶管阻滞；B组单纯应用0.25%布比卡因行骶管阻滞。比较两组患儿术后PAED评分、FLACC疼痛评分及脸谱疼痛评分。记录麻醉诱导前，骶管阻滞前，骶管阻滞后每隔10 min的HR、MAP、SpO2、ETCO2。结果 两组患儿T1～T6期间HR、MAP、SpO2差异,无统计学意义（P>0.05）。B组呼气末七氟醚浓度（1.93±0.33）vol%高于B-D组（1.22±0.21）vol%，差异有统计学意义（P<0.05）。B-D组术后脸谱疼痛评分、FLACC 评分及PAED评分优于B组，差异具有统计学意义（P<0.05）。结论 右美托咪定复合布比卡因骶管阻滞能有效减少七氟醚小儿麻醉苏醒期躁动发生。

Observation of Dexmedetomidine Combined with Bupivacaine Caudal Block in Preventing Sedation in Children with Sevoflurane during Anesthesia Recovery Period

Abstract:Objective To observe the effect of dexmedetomidine combined with bupivacaine caudal block in preventing postoperative restlessness after sevoflurane anesthesia in children.Methods Select 2 to 6-year-old elective cramps,hydrocele,hypospadias, cryptorchidism in 60 cases of children treated.All patients were ASA grade 1 and all received sacral canal block.They were randomly divided into two groups,30 in each group.Group B-D received 0.25% bupivacaine combined with 1.5μg/kg dexmedetomidine for sacral block,while group B used 0.25% bupivacaine alone for sacral block.Postoperative PAED score,FLACC pain score and facial pain score were compared between the two groups.HR,MAP,SPO2 and ETCO2 were recorded every 10 min before sacral block before anesthesia induction.Results There was no significant difference in HR,MAP and SpO2 between the two groups during T1~T6(P>0.05).The concentration of end tidal sevoflurane in group B(1.93+0.33)vol% was higher than that in group B-D(1.22+0.21)vol%,the difference was statistically significant(P<0.05).Postoperative pain score,FLACC score and PAED score in group B-D were better than those in group B,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with bupivacaine sacral block can effectively reduce the incidence of restlessness in children with sevoflurane during anesthesia recovery period.