右美托咪定对slJL扁桃体和／或腺样体术后躁动的影响

目的观察小剂量右美托咪定（dexmedetomidine，Dex）对小儿七氟烷全麻扁桃体和／或腺样体术后苏醒期躁动的影响。方法选取年龄2岁～8岁，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级，拟在七氟烷吸入麻醉下进行扁桃体和／或腺样体摘除的患儿90名，采用双盲法以抽签形式将患者随机分为两组（每组45例）：实验组（D组）和对照组（s组）。D组在诱导时给予Dex负荷量0.3μg／kg（10min泵人），后以0．2μg·kg-1·h-1维持；S组给予等容生理盐水，两组麻醉均以七氟烷维持，记录患者心率（heart rate，HR）、血压、脉搏血氧饱和度、呼气末七氟烷浓度、停药到自主呼吸恢复时间、停药至拔管时间、拔管后躁动评分。结果D组苏醒期躁动发生率为28.89％，S组为64.44％，且每个时间记录点D组发生躁动的人数均少于S组。结论小剂量Dex能减轻小儿七氟烷全麻扁桃体和／或腺样体术后苏醒期躁动。

The effect of low dose dexmedetomidine on emergence agitation after adenotossillec-tomy and/or adenoidectomy in children by sevoflurane anesthesia

Objective To observe the effect of low dose dexmedetomidine on emergence agitation after tonsillectomy and/or adenoidectomy in children with sevoflurane anesthesia. Methods Ninety children, aged 2 y-8 y, ASA Ⅰ-Ⅱ , undergoing adenotonsillectomy and/or Adenoidectomy, were randomly divided into two groups： the dexmedetomidine group（D group, n=45） and the saline group （S group, rt =45）. Anesthesia was maintained with sevoflurane and oxygen. D group patients were given dexmedetomidine 0.3 μg/kg （in 10 min） and maintained with 0.2 μg ·kg-1·h-1. The S group was given the same dosage saline. Intraoperative hemodynamics were recorded every 5 rain. Time of spontaneous breathing, time of extubation, and the emergence agitation in PACU were recorded. Results The incidence of emergence agitation was 28.89% in group D, and 64.44 % in group S, the mean agitation scores in the D group were lower than the S group except at 10 rain. Conclusions So low dose dexmedetomidine could reduce the emergence agitation in children receiving sevoflurane undergoing tonsillectomy and/or adenoidectomy.