右美托咪定复合七氟烷麻醉对小儿疝气手术中循环指标及苏醒质量的影响

目的]探讨右美托咪定复合七氟烷对小儿疝气手术中循环指标及苏醒质量的影响.方法]本院择期行腹腔镜疝修补、疝囊高位结扎术的疝气患儿76例随机分为两组,各38例.右美托咪定组(A组)气管插管后微泵静脉注射右美托咪定0.2 μg/(kg·h),对照组(B组)给予同等剂量的生理盐水静脉泵注.比较两组手术情况及进入麻醉恢复室即刻(0 min)、30 min躁动评分,术前(T0)、麻醉诱导后(T1)、手术开始5 min(T2)、10 min(T3)、术毕(T4)、患儿心率(HR)、平均动脉压(MAP)水平,并发症发生率.结果]两组苏醒时间、拔管时间比较差异无显著性(P>0.05),A组进入恢复室后0 min、30 min躁动评分低于对照组(P<0.05).与T0时点比较,A组T1时点HR上升,T2时点下降,对照组T1～4时点HR均上升,T1～2时点MAP上升,且差异有显著性(P<0.05);A组T1～4时点HR均低于B组,T2～3时点MAP低于B组(P<0.05).A组全麻苏醒期躁动(EA)发生率为7.89％(3/38),低于B组的39.47 ％(15/38)(P<0.05).结论]小儿疝气手术中采用右美托咪定复合七氟烷麻醉,不仅可维持术中血流动力学稳定,还可提高苏醒质量,降低EA发生率.

Effect of Dexmedetomidine Combined with Sevoflurane Anesthesia on Circulatory Indicators and Recovery Quality in Pediatric Hernia Surgery

Objective]To investigate the effect of dexmedetomidine combined with sevoflurane on the circulatory indicators and recovery quality in pediatric hernia surgery.Methods] Seventy-six children with hernia surgery were randomized into two groups, with 38 cases in each.The Dexmedetomidine group (A group) was treated with intravenous injection of dexmedetomidine 0.2 μg/(kg h) by micro pump after tracheal intubation, while the control group (B group) was treated with intravenous infusion of normal saline in the same dose.The operation time, recovery time, extubation time and agitation scores at 0 min and 30 min after entering the recovery room were compared between the two groups.Heart rate (HR) and mean arterial pressure (MAP) were recorded before operation (T0), after anesthesia induction (T1), 5min (T2) and 10min (T3) after the beginning of operation, and the end of operation (T4).Results] There were no significant differences between the two groups in terms of recovery time and extubation time (P>0.05).At 0 min and 30min after entering the recovery room, the agitation scores of patients in A group were lower than those in B group (P<0.05).Compared to T0, HR of A group was increased at T1 and decreased at T2.From T1～T4, HR of B group increased, and MAP increased at T1～T2(P<0.05).From T1～T4, HR of A group was lower than of B group, and at T2～T3, MAP was lower than that of B group (P<0.05).The incidence rate of emergence agitation (EA) during the recovery period of general anaesthesia in A group was 7.89％ which was lower than that in B group (39.47％) (P<0.05).Conclusion] Using dexmedetomidine combined with sevoflurane in pediatric hernia surgery not only can maintain hemodynamic stability during operation, but also can improve the recovery quality, and reduce the incidence rate of EA.