盐酸右美托咪定复合眶下神经阻滞在小儿唇裂修补术的应用

Dexmedetomidine Combined with Infraorbital Nerve Block in Infant for Cleft Lip Repair Surgery

目的探讨全麻小儿唇裂修补术中使用右美托咪定复合眶下神经阻滞的安全性及有效性.方法：48 例ASAⅠ级择期行唇裂修补术的小儿患者,年龄6 月～1 岁,将其随机分成右美托咪定组（A 组）和对照组（B 组）,每组各24 例.常规全麻诱导后气管插管,实验组行右美托咪定复合眶下神经阻滞后开始手术,对照组泵注同样剂量生理盐水.术中用七氟醚吸入维持麻醉.观察记录入室时（T0）﹑手术结束时（T1）﹑气管拔管时（T2）﹑气管拔管后5min（T3）各时间点平均动脉压（MAP） ﹑心率（HR）,记录麻醉苏醒时间和术后患儿苏醒后是否有躁动.结果：A 组患者T0、T1、T2的MAP 和HR 明显低于B 组（P〈0.05）,术后A 组躁动的发生率低于B 组（P〈0.01）,A 组麻醉苏醒时间短于B 组（P〈0.01）.结论：右美托咪定复合双侧眶下神经阻滞可使患儿拔管期血流动力学更稳定,躁动发生率低,麻醉苏醒时间更短,适宜在临床推广应用.

ObjectiveTo observe the safety and effectivity of dexmedetomidine combined with infraorbital nerve block in infant for cleft lip repair surgery. Methods：48pediatric patients, ASA I, aged 6 months～1 years, were randomly divided into dexmedetomidine group（group A） and controlled group （group B） （n=24）. Sevoflurane inhalationanesthesia were performed to two groups. Group A was treated with dexmedetomidine combined with infraorbital nerve block and group B was treated with physiological brine. MAPand HR were recorded at 4 time points, upon entering the operating room（T0）, at the end of the surgery（T1）, during extubation（T2） and 5min after extubation（T3）. Awaking time andincidence of postoperative restlessness were compared. Results：MAP, HR at T0, T1, T2 in group A were significantly lower than those in group B（P〈0.05）.The incidence ofpostoperative restlessness in group A was lower compared with group B（P〈0.01）.Awaking time in group A were significantly shorter than those in group B（P〈0.01）.Conclusions：Dexmedetomidine combined with infraorbital nerve block is safe and effective in infant for cleft lip repair surgery.