右美托咪定对小儿腹腔镜手术麻醉恢复期躁动的影响分析

The impact of dexmedetomidine on restlessness during anesthesia recovery period after pediatric laparoscopic surgery

目的分析右美托咪定对小儿腹腔镜疝气手术麻醉恢复期躁动的影响。方法择期行腹腔镜疝气手术患儿82例，实验组麻醉诱导前10rain静脉泵注右美托咪定0．5μg／kg加生理盐水20ml；常规组泵注等容量生理盐水；观察两组麻醉恢复期躁动情况、麻醉与术后情况、HR与MAP变化情况。结果实验组患儿T1、T2与T3的HR、MAP水平均低于常规组，差异均有统计学意义（均P〈0．05）。实验组患儿麻醉恢复期躁动发生率12．20％、躁动持续时间（7．65±1．63）min、躁动评分（1．55±0．65）分、镇静评分（2．10±0．78）分，均明显优于常规组（X2=10．2122，t=8．3613，t=6．833l，t=5．4599），差异均有统计学意义（均P〈0．05）。两组患儿拔管时间与麻醉恢复时间无明显差异（P〉0．05）；实验组呼吸道不良事件发生率9．76％明显低于常规组34．15％，（X2=4．9697，P=0．0260），差异有统计学意义（P〈0．05）。结论小儿腹腔镜疝气手术中，泵注右美托咪定可有效降低麻醉恢复期躁动发生率，降低呼吸道不良事件的发生率，麻醉过程平稳，镇静效果显著。

Objective To analyze the effect of dexmedetomidine on restlessness during anesthesia recovery period after pediatric laparoscopic hernia surgery. Methods 82 children scheduled for laparoscopic hernia surgery were selected, the experimental group received intravenous pumping of 0.5μg/kg of dexmedetomidine and normal saline 20 ml at 10 min before anesthesia induction, while the conventional group received intravenous pumping of equal volume of normal saline. Observed the restlessness during anesthesia recovery period of the two groups, anesthesia and postoperative condition, changes of HR and MAP. Results The levels of HR and MAP at T1, T2 and T3 in the experimental group were lower than those in the conventional group （P〈0.05）. The rate of restlessness during anesthesia recovery period in the experimental group was 12.20%, the duration of restlessness was （7.65±1.63）min, the score of restlessness was （1.55±0.65） points, the sedation score was （2.10±0.78） points, which were significantly superior to the conventional group （X2=10.212 2, t=8.361 3, t=-6.833 1, t=-5.459 9; P〈0.05）. There were no statistically significant differences in extubation time and anesthesia recovery time between the two groups （P〉0.05）. The incidence of respiratory adverse events in the experimental group was significantly lower than that in the conventional group （9.76% vs.34.15%; X2=4.9697,P=0.026 0）. Conclusion In pediatric laparoscopic hernia surgery, pump injection of dexmedetomidine can effectively reduce the incidence of restlessness during anesthesia recovery period and the incidence of respiratory adverse events, with smooth anesthesia process and remarkable sedative effect.