右美托咪定及小剂量氯胺酮对小儿全身麻醉苏醒期躁动的疗效对比

目的探讨右美托咪定及小剂量氯胺酮对小儿全身麻醉苏醒期躁动的效果及安全性。方法选择2011年2月~2013年2月在全身麻醉下行腺样体扁桃体切除手术患儿66例,将其随机分为右美托咪定组、氯胺酮组、对照组,各22例,麻醉诱导后气管插管,3组分别注入右美托咪定1μg/kg 10 ml,氯胺酮0.2 mg/kg 10 ml,生理盐水10 ml。观察及比较3组心率、血压、血氧饱和度、躁动发生率、躁动评分及唤醒时间。结果右美托咪定组和氯胺酮组拔管时、拔管后心率和平均动脉压较对照组低,差异有统计学意义（P〈0.05）;右美托咪定组拔管时、拔管后心率和平均动脉压较氯胺酮组低,差异有统计学意义（P〈0.05）。3组躁动发生率、躁动评分比较差异均有统计学意义（P〈0.05）。结论右美托咪定及小剂量氯胺酮均可有效预防小儿苏醒期躁动,右美托咪定效果更安全。

Curative effect contrast of dexmedetomidine and low-dose ketamine on infantile dysphoria during revival period in full anesthesia

Objective To investigate the effect and safety of dexmedetomidine and low-dose ketamine on infantile dysphoria during revival period in full anesthesia. Methods Sixty-six children received adenotonsillectomy under general anesthesia from February 2011 to February 2013 were selected and randomly divided into three groups（dexmedetomidine group,low-dose ketamine group and control group）,22 children in each group.After endotracheal intubation under anesthesia induction, the children in dexmedetomidine group were treated with pump infection of dexmedetomidine（1 μg/kg,10 ml）,the children in low-dose ketamine group were treated with pump infection of low-dose ketamine（0.2 mg/kg,10 ml）,the children in control group were treated with pump infection of normal saline（10 ml）.The heart rate,blood pressure,oxygen saturation,incidence rate of agitation,restlessness score and wake up time of three groups were observed and compared. Results Heart rate and mean arterial pressure in dexmedetomidine group and ketamine group at extubation and after extubation was lower than that in control group respectively,with statistical difference（P〈0.05）.Heart rate and mean arterial pressure in dexmedetomidine group at extubation and after extubation was lower than that in ketamine group respectively,with statistical difference（P〈0.05）.Incidence rate of agitation,restlessness score in three groups was compared respectively,with statistical difference（P〈0.05）. Conclusion Both dexmedetomidine and low-dose ketamine can prevent infantile dysphoria during revival period,and dexmedetomidine is more safer.