右美托咪定辅助麻醉在儿童扁桃体切除术中的应用

Application of dexmedetomidine assisting anesthesia in children with tonsillectomy

目的:探讨右美托咪定(DEX)辅助麻醉用于儿童扁桃体切除术的有效性和安全性。方法:选择扁桃体切除术患儿60例,随机分为DEX辅助麻醉组(DEX组)和常规麻醉组(对照组)各30例。DEX组患儿静脉给予DEX 1μg/kg微量泵泵注,对照组给予等容量0.9%氯化钠注射液微量泵泵注,后行局部浸润麻醉。观察给药前、给药10 min、手术开始时、手术结束时的平均动脉压与心率的变化。并记录2组芬太尼的使用量、出血量以及呼吸抑制、恶心呕吐等不良反应。结果:DEX组的麻醉效果明显优于对照组(P<0.01)。DEX组患儿在手术开始时和手术结束时的平均动脉压与心率均显著低于对照组(P<0.01);DEX组的出血量和芬太尼使用量均显著少于对照组(P<0.01)。结论:DEX辅助麻醉应用于儿童扁桃体切除术,镇痛、镇静效果良好,循环稳定,术后苏醒快,无呼吸抑制等不良反应。

Objective：To investigate the safety and efficacy of dexmedetomidine （ DEX ） assisting anesthesia in children with tonsillectomy. Methods：Sixty children treated with tonsillectomy were randomly divided into the DEX assisting anesthesia group（ DEX group） and the regular anesthesia group（control group）（30 cases in each group）. The DEX group and control group were treated with 1 μg/kg of DEX and 0. 9% sodium chloride injection by microinjection pump,respectively. The mean arterial pressure and heart rate in two groups were observed before injection, 10 min after injection, the beginning of operation and end of operation. The amount of bleeding and consumption of fentanyl,respiratory depress,nausea and vomiting in two groups were recorded. Results：The efficacy of anesthesia in DEX group was better than that in control group（P〈0. 01）. The mean arterial pressures and heart rates at the beginning of operation and end of operation in DEX group were significantly lower than those in control group（P〈0. 01）. The amount of bleeding and consumption of fentanyl in DEX group were significantly less than those in control group（P〈0. 01）. Conclusions：DEX assisting anesthesia can be used in tonsillectomy children, the good analgesia and sedation effects, stable circulation, quick palinesthesia and without respiratory depression are found.