右美托咪定预防小儿七氟烷麻醉后苏醒期的躁动反应

Dexmedetomidine for Preventing the Agitation after Sevoflurane Anesthesia in Pediatric Patients During Wakefulness

[目的]探讨右美托咪定对小儿七氟烷麻醉后苏醒期躁动的预防作用。[方法]本院80例急诊手术患儿，按实验设计分成右美托咪定组（A组）和对照组（B组），每组40例。两组患儿均采用七氟烷吸入诱导，气管插管后行机械通气，术中予吸入七氟烷-空氧混合气体维持。A组在此基础上连续静脉输注右美托咪定0．5μg/（kg ＆#183; h ）至手术结束前5 min停用。采用改良Aldrete评分、PAEDS评分和CHEOPS评分对两组患儿的复苏状况、苏醒期躁动和术后疼痛进行评估。[结果]两组患儿麻醉后恢复室（PACU）停留时间相比较差异无显著性（ P＞0．05），A组苏醒期各时间段躁动发生率均小于B组（ P＜0．05）。两组患儿各时段改良 Aldrete评分比较无统计学差异。入PACU后B组各时点PAEDS评分均高于 A组（ P ＜0．05），且第20 min和第30 min B组CHEOPS评分高于 A组（ P ＜0．05）。[结论]静脉连续输注右美托咪定不会显著延长小儿的苏醒时间，且苏醒过程中躁动的发生率明显降低，因此右美托咪定能预防小儿七氟烷麻醉后苏醒期的躁动反应。

[Objective] To explore dexmedetomidine for preventing the agitation after sevoflurane anesthesia in chil-dren during wakefulness .[Methods]According to experimental design ,80 pediatric patients with emergency operation in our hospital were randomly assigned into dexmedetomidine group （Group A） and control group（Group B） with 40 cases in each group .Pediatric patients in both groups were given mechanical ventilation after tracheal intubation under sevoflurane induction inhalation ,and then inhaled with sevoflurane and oxygen-air mixed gas for anesthesia maintenance .Additional-ly ,Group A received continuous intravenous infusion with dexmedetomidine 0 .5μg/kg/hr until 5min before the end of surgery .The modified Aldrete scale ,PAEDS score and CHEOPS score were used to evaluate the resuscitation state ,agi-tation during wakefulness and postoperative pain .[Results] There was no significant difference of stay time in postanes-thetic recovery room（PACU） between two group（ P＆gt;0 .05） .The incidence of agitation in Group A at each period during wakefulness was lower than that in Group B （ P＆lt;0 .05） .There was no significant difference in modified Aldrete score at each period between two groups .PAEDS score of Group B in PACU at each time point was higher than that of Group A （ P＆lt;0 .05） ,and CHEOPS scores of Group B at 20min and 30min were higher than those of Group A （ P＆lt;0 .05） .[Con-clusion]Continuous intravenous infusion with dexmedetomidine （0 .5μg/kg/hr） can not markedly prolong the recovery time in children ,but obviously reduce the incidence of agitation during wakefulness .Therefore ,dexmedetomidine can prevent the agitation after sevoflurane anesthesia in children during wakefulness .