右美托咪定对小儿七氟烷吸入麻醉苏醒期躁动的影响

目的探讨右美托咪定对小儿七氟烷吸入麻醉苏醒期躁动的影响。方法选择2011年3月-2012年1月美国麻醉医师协会分级Ⅰ～Ⅱ级、年龄2～8岁、择期行疝囊高位结扎术和隐睾下降固定术患儿40例,随机分为2组,右美托咪定组(A组)和对照组(B组),两组患儿在年龄、体重、手术种类无明显差异。两组患儿均采用面罩8%七氟烷吸入麻醉诱导,开放静脉,给予盐酸戊乙奎醚0.1 mg/kg、顺式阿曲库铵0.15 mg/kg,插入喉罩,麻醉维持根据血压、心率及脑电双频指数调节吸入麻醉药浓度。A组静脉给予1μg/kg右美托咪定,B组给予同等容量的生理盐水。入室至手术结束时连续观察收缩压、舒张压、心率、血氧饱和度,记录清醒时间、拔除喉罩时间,记录苏醒期并发症的发生数。记录入麻醉恢复室即刻(0 min)、15、30、60、90 min患儿疼痛和躁动评分。结果两组患儿在手术时间、清醒时间以及拔除喉罩时间差异无统计学意义(P>0.05),A组术后入恢复室0、15、30 min疼痛评分和躁动评分均低于B组(P<0.05),两组患儿围术期均未出现低血压和心动过缓。结论右美托咪定用于小儿七氟烷吸入麻醉能够增强术后镇痛,减少苏醒期躁动。

The Effect of Dexmedetomidine on the Agitation Induced by Sevoflurane during the Recovery Period of General Anesthesia in Children

Objective To investigate the effect of dexmedetomidine on the agitation induced by sevoflurane during the recovery period of general anesthesia in children.Methods Forty ASAⅠ-Ⅱchildren aged 2-8 years undergoing high ligation of hernia sac and fixation of cryptorchidism were randomized into 2 groups(n=20 each): group A and group B.The children in each group were treated with 8% sevoflurane with mask inhalation for induction of anesthesia.They were intravenously injected with 0.1 mg/kg penehyclidine hydrochloride and 0.15mg/kg cis-atracurium besylate followed by insertion of laryngeal mask.The concentration of inhaled anesthetics was regulated according to BP,HR and BIS in order to maintain anesthesia.The children in group A were intravenously injected with 1 μg/kg dexmedetomidine and the children in group B were intravenously injected with an equal volume of normal saline.SBP,DBP,HR and SpO2 were continuously observed from entering the operating room to the end of surgery.The recovery time,the time of LMA removal and the incidence of complications during recovery period were recorded.Pain scores and agitation scores were measured 0,15,30,60 and 90 min after entry into the recovery room.Results There were no significant differences in age,weight,type of surgery,time of surgery,recovery time and time of LMA removal between the two groups(P>0.05).The scores of pain and agitation in group A were significantly lower than those in group B at 0,15 and 30 min after entry into the recovery room(P<0.05).The hypotension and bradycardia did not occur in both groups.Conclusion Dexmedetomidine can reduce the agitation induced by sevoflurane during the recovery period of general anesthesia in children.