右美托咪定对小儿腹腔镜手术吸入全麻七氟烷MAC与术后躁动的影响

目的探讨右美托咪啶对小儿腹腔镜手术吸入全麻七氟烷MAC及术后躁动的影响。方法选择2011年1月至2014年6月拟行腹腔镜腹股沟斜疝手术患儿60例，双盲法分为观察组和对照组，每组各30例，观察组给予Dex0．4μg／kg，于10min以上泵注完，然后持续泵注Dex0．4μg/（kg·h）；对照组给予等容量0．9％氯化钠溶液同时间内泵注，然后持续泵注等容量0．9％氯化钠溶液。术中吸入七氟醚维持麻醉深度在Bis45～55，观澳0两组维持七氟醚MAC值、患儿苏醒拔管时间及术后躁动发生情况。结果在相同的麻醉深度下（Bis值保持在45～55），观察组维持吸入七氟醚MAC（1．9±0．3）较对照组（2．2±0．4）低，差异有统计学意义（t=3．29，P〈0．01）；观察组术后躁动发生率（6．7％）较对照组（26．7％）低，差异有统计学意义（Х^2=4．32，P〈0．05）；两组苏醒时间（10．4±2．5），（9．7±2．0）]比较差异无统计学意义（t=1．20，P〉0．05）。结论Dex用于小儿吸入全麻腹腔镜手术，能有效降低吸入七氟醚的MAC值，减少其用药量，降低患儿术后躁动发生率。

Effects of dexmedetomidine on sevoflurane MAC and postoperative agitation in pediatric laparoscopic surgery inhalation anesthesia

Objective To investigate the effeets of dexmedetomidine on sevoflurane MAC and postoperative agitation in pediatrie laparoseopic surgery inhalation anesthesia. Methods 60 eases for laparoscopic inguinal hernia surgery in children, were divided with double-blind way into observation group and control group （n=30）. Observation group was given infusion Dex 0.4 μg/kg, in over 10 rains, and then used continuous infusion Dex 0.4 μg/（kg· h）; while the control group received the same volume of 0.9% sodium chloride solution at the same time infusion, continuous infusion, sueh as capacity and 0.9% of sodium chloride solution. Intraoperative anesthesia was maintained with sevoflurane depth Bis 45-55, we observed the sevoflurane MAC values, children awake extubation time and postoperative restlessness occurrence in two groups. Results Under the same depth of anesthesia （Bis 45-55）, the observation group＇ s maintaining the MAC sevoflurane inhalation （1.9± 0.3） was lower compared with that of the control group （2.2 ±0.4）, the difference was statistically significant （t=3.29, P 〈 0.01）; restlessness occurrence rate of the observation group （6.7%） was lower than that of the control group （26.7%）, the difference was statistically significant （Х^2=4.32, P 〈 0.05）; recovery time of the two groups showed no statistical significant difference （10.4 ± 2.5）, （9.7± 2.0）, t=1.20, P 〉 0.05]. Conclusion Dex used in inhalation anesthesia for pediatric laparoseopic surgery, can effectively reduce the sevoflurane MAC value, reduce its dosage and the incidence of postoperative agitation in children.