右美托咪定对扁桃腺切除术患儿七氟醚复合麻醉苏醒期躁动的影响

目的] 探讨右美托咪定对扁桃腺切除术患儿七氟醚复合麻醉苏醒期躁动的影响.方法] 本院拟在全麻气管插管下行扁桃体切除手术的患儿80例,随机分为观察组和对照组,每组各40例,全部患者都静脉注射芬太尼2 μg/kg,异丙酚3 mg/kg,顺阿曲库铵0.2 mg/kg,完成诱导气管插管,手术过程中为患者吸入2%~3.5%七氟醚以维持麻醉效果.观察组插入气管导管后,输注右美托咪定0.5 μg/kg,对照组则输注等剂量的生理盐水,比较两组麻醉苏醒期躁动发生情况.结果] 观察组小儿苏醒期烦躁量表 (PAED)评分(8.0±1.5)明显低于对照组的(11.9±1.7),且差异有显著性(P<0.05).观察组的躁动发生率、不良反应发生率均明显低于对照组(P<0.05).观察组麻醉后恢复室(PACU)停留时间明显低于对照组(P<0.05).观察组手术时间、拔管时间与对照组的比较差异均无显著性(P<0.05).结论] 使用右美托咪定有助于减少患儿苏醒期躁动,帮助患儿平稳度过麻醉苏醒期,并减少术后的不良反应,值得临床推广运用.

Effect of Dexmedetomidine on Post-Anesthesia Delirium in Children Undergoing Tonsillectomy with Sevoflurane Combined Anesthesia

Objective]To study the effect of dexmedetomidine on post-anesthesia delirium in children undergoing tonsillectomy with sevoflurane anesthesia.Methods]A total of 80 cases of tonsillectomy in children under general anesthesia were randomly divided into an observation group and a control group, with 40 cases in each group.All patients received intravenous injections of fentanyl 0.2 g/kg, propofol 3mg / kg, and cis atracurium 0.2mg/kg for the intubation of the endotracheal tube.Then, all patients inhaled 2%~3.5% sevoflurane to maintain anesthesia during operation.After inserting endotracheal tube, patients in the observation group received dexmedetomidine injection 0.5μg/kg while patients in the control group received the same dosage of saline injections.Post-anesthesia agitation in the two groups during the anesthesia recovery period was compared.Results]PAED (Pediatric Anesthesia Emergence Delirium Scale) score of the observation group (8.0±1.5) was significantly lower than that of the control group (11.9±1.7), and the difference was statistically significant (P<0.05).The incidence of agitation and adverse reactions in the observation group was significantly lower than that in the control group (P<0.05).The PACU (Post-Anesthesia Care Unit) retention time of the observation group was significantly lower than that of the control group (P<0.05).The operation time and extubation time of the control group and observation group was not statistically significant (P>0.05).Conclusion]Dexmedetomidine can reduce infant restlessness and help children smoothly wake up during the anesthesia recovery period.It also reduces postoperative adverse reactions.So, it is worth being popularized in clinical application.