右美托咪定对腹腔镜氯胺酮麻醉患儿血流动力学及术后苏醒期并发症的影响

【目的】观察右美托咪定对腹腔镜氯胺酮麻醉患儿血流动力学及术后苏醒期并发症的影响。【方法】选择在本院择期进行腹腔镜手术的76例患儿，A S AⅠ～Ⅱ，按随机表法分为C组（氯胺酮麻醉）与D组（右美托咪定＋氯胺酮麻醉）两组，每组38例，两组均采用氯胺酮麻醉，D组术前15 m静脉泵注右美托咪定05．μg／kg。分别记录手术即刻（T0）、气腹后30min（T1）、术毕（T2）、拔管时（T3）、拔管后5 min（T4）、患者心率（HR）、收缩压（SBP）、舒张压（DBP）变化；记录比较两组手术时间、麻醉时间、苏醒时间，苏醒期恶心、呕吐，寒颤，躁动发生率。【结果】两组手术时间、麻醉时间相比较差异无显著性（P＞00．5），D组苏醒时间显著长于C组（P＜00．5）；D组T0、T1、T2、T3、T4各时点HR、DBP、SBP均低于C组（P＜00．5）；D组苏醒期恶心、呕吐，寒颤，躁动发生率均显著低于C组，且差异有显著性（P＜00．5）。【结论】右美托咪定可稳定腹腔镜氯胺酮麻醉患者血流动力学，降低术后苏醒期并发症发生率。

Effect of Dexmedetomidine on Hemodynamics and Postoperative Complications in the Recovery Pe-riod of Laparoscopic Ketamine Anesthesia

Objective]To observe the effect of dexmedetomidine on hemodynamics and postoperative complications in the recovery period of laparoscopic ketamine anesthesia .Methods]Seventy‐six cases of children who were ASAⅠ~Ⅱand underwent elective laparoscopic surgery at our hospital were selected as study objects .According to the random num‐ber table method ,the children were divided into group C (ketamine anesthesia) and group D (dexmedetomidine combined with ketamine anesthesia) ,with 38 cases in each group .Patients in both groups received ketamine anesthesia .Patients in the group D were infused with dexmedetomidine 0 5.μg/kg at 15min before operation .The changes in heart rate (HR) , systolic blood pressure (SBP) ,and diastolic blood pressure (DBP) were recorded immediately at operation (T0 ) ,30min after pneumoperitoneum (T1 ) ,at the end of operation (T2 ) ,at extubation (T3 ) ,and 5min after extubation (T4 ) .The operation time ,anesthesia time ,recovery time ,incidence rates of nausea ,vomiting ,shivering ,and dysphoria in the two groups were recorded .Results]①There were no significant differences in operation time and anesthesia time between the two groups ( P >0 0.5) .The average recovery time of patients in group D was longer than that of patients in group C ( P <0 0.5) .② At T0 ,T1 ,T2 ,T3 ,and T4 ,HR ,DBP ,and SBP of patients in group D were lower than those of pa‐tients in group C ( P <0 0.5) .③ The incidence rates of nausea ,vomiting ,shivering ,and dysphoria in patients in group D were lower than those of patients in group C ( P <0 0.5) .Conclusion]Dexmedetomidine can stablize hemodynamics in children receiving laparoscopic ketamine anesthesia and reduce the incidence of postoperative complications in the recovery period .