不同剂量右美托咪啶对小儿七氟烷麻醉术后急性躁动及睁眼时间的影响

目的：探讨右美托咪啶用于减轻小儿七氟烷麻醉术后急性躁动的有效剂量。方法将105例ASAⅠ～Ⅱ级行手术的患儿采用数字表法随机分为三组，每组35例，患儿吸入3％七氟烷进行麻醉诱导，对照组患儿静脉注射0．9％氯化钠注射液2 mL，观察1组患儿注射右美托咪啶0．15μg/kg，观察2组患儿注射右旋美托咪啶0．30μg/kg，然后放置口咽通气道辅助通气，行骶管阻滞。麻醉维持使用1．2％七氟烷，维持其自主通气。记录患儿血流动力学和呼吸的改变。在麻醉结束时记录睁眼的时间（ TEO ）。结果对照组、观察1组、观察2组TEO分别为（8．45±4．02）min、（9．23±5．03）min、（10．81±4．06）min，差异均无统计学意义（均P＞0．05）。观察1组的躁动发生率（20．00％）显著低于对照组（42．86％）（χ^2＝31．42，P＜0．05），观察2组（8．57％）显著低于对照组和观察1组（χ^2＝24．37、7．53，均P＜0．05）。结论右美托咪啶可有效预防小儿七氟烷麻醉术后急性躁动，0．30μg/kg剂量既有效又安全。

Influence of different dose dexmedetomidine on postoperative acute agitation and time to eyes opening in pediatric sevoflurane anesthesia

Objective To investigate the effective dose of dexmedetomidine on reducing agitation after sevoflurane anesthesia in patients undergoing repair of indirect inguinal hernia .Methods 105 patients （ ASAⅠ-Ⅱ） were randomly assigned into three groups ,35 cases in each group .In the observation group 1 and observation group 2, the patients received intravenous injection of dexmedetomidine 0.15μg/kg and 0.30μg/kg respectively.In the control group,the patients received intravenous injection of 0.9% normal saline solution 2mL before surgery.All patients were induced by 3%sevoflurane and maitained by 1.2%sevoflurane and hiatus sacralis block .During the operation, the BP,HR,SpO2,RR were recorded.At the end of anesthesia,the time to eyes opening （TEO） and agitation of emer-gence were recorded.Results The TEO of the control group,observation group 1,observation group 2 was （8.45 ± 4.02）min,（9.23 ±5.03）min,（10.81 ±4.06）min,respectively,and there were no significant differences among the three groups（all P〉0.05）.The incidence rate of agitation of the observation group 1 was 20.00%,which was signifi-cantly lower than that in the control group （42.86%） （χ^2 =31.42,P〈0.05 ）,and that of the observation group 2（8.57%） was significantly lower than the control group and observation group 1（χ^2 =24.37,7.53,all P〈0.05）. Conclusion The dose of dexmedetomidine 0.3μg/kg administered after induction of anesthesia can reduce the post-sevoflurane agitation in children and with no adverse effects .