右美托咪啶预防婴幼儿唇裂地氟烷麻醉术后躁动的有效剂量

目的评估右美托咪定用于预防儿童唇裂地氟烷术后躁动的有效剂量。 方法选择2016年5月至2016年7月行择期唇裂修复术患儿21例，年龄6 ~ 24月龄。常规麻醉诱导后，在手术前给予右美托咪定，术中使用地氟烷维持麻醉。术后评估患儿躁动情况，评估时间点为患儿到达恢复室即刻、到达恢复室15和30 min；根据改良序贯法试验，第一例患儿使用右美托咪定0.5 mcg/kg，若患儿未出现躁动，则下一例患儿右美托咪定剂量减少0.1 mcg/kg；若患儿出现躁动，则下一例患儿右美托咪定剂量增加0.1 mcg/kg，采用逻辑回归法计算右美托咪定预防躁动的50%和95%有效剂量及其95%可信区间（CI）。 结果右美托咪定预防躁动的50%为0.27 mcg/kg（95% CI为0.16 ~ 0.36 mcg/kg），95%有效剂量为0.39 mcg/kg（95% CI为0.29 ~ 0.45 mcg/kg）。 结论右美托咪定可有效预防地氟烷麻醉儿童唇裂手术引起的术后躁动，其有效剂量需要更多的研究来验证。

Effective dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for cleft lip repair surgery in children

ObjectiveTo evaluate the effective dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for patients undergoing a cleft lip repair surgery in children. MethodsTwenty-one American Society of Anesthesiology Classification (ASA) Ⅰ orⅡchildren, scheduled for elective cleft lip repair surgery under general anesthesia, were enrolled in the study. After general anesthesia induction, dexmedetomidine was administered before surgery. Emergence agitation (EA) (agitation measured at level 4 or more at least once) was assessed on arrival in the postanesthetic care unit (PACU) , 15 min later, and 30 min later. The dose of dexmedetomidine for consecutive patients was determined by the response of the previous patient, using an increment or decrement of 0.1 mcg/kg. ResultsThe 50% effective dose of dexmedetomidine for prevention of EA was 0.27 mcg/kg (95% CI: 0.16-0.36 mcg/kg) , and the 95% effective dose was 0.39 mcg/kg (95% CI: 0.29-0.45 mcg/kg) . ConclusionsDexmedetomidine can effectively prevent children′s emergence agitation after cleft lip repair surgery by desflurane anesthesia. Further study is needed to validate the suggested dose of dexmedetomidine to prevent the EA that was identified in the present study.