右美托咪定在预防七氟醚麻醉小儿苏醒期躁动中的临床价值研究

Study of the Clinical Value of Dexmedetomidine in Prevention of Sevoflurane Restlessness in Children

目的探讨分析右美托咪定在预防七氟醚麻醉小儿苏醒期躁动中的临床价值。方法选取2014-03～2015-01间在我院收入治疗的扁桃体剥离合并腺样体吸切术患儿72例,随机平分为对照组和观察组,观察组患儿静脉持续泵入1μg/kg·h右美托咪定,对照组患儿泵入同量生理盐水,比较两组患儿的各时段平均动脉压（MAP）、心率（HR）、躁动发生率（EA）、儿童麻醉苏醒期躁动评分（PAED）、疼痛程度评分（CHEOPS）差异及术后不良反应发生率差异。结果观察组患儿各时段MAP、HR较对照组变化小,更为平稳,且其各时段EA发生率、PAED评分和CHEOPS评分均明显低于对照组;观察组患儿术后发生不良明显低于对照组。结论右美托咪定能够较好稳定患儿麻醉过程中的动脉压及心率,降低患儿七氟醚麻醉苏醒期中的躁动发生率及术后不良反应发生率,值得临床应用。

Objective To study the clinical value of dexmedetomidine in preventing sevoflurane restlessness in children. Methods 72 children with adenoid tonsil suction stripped merger resection were selected in the hospital from March,2014 to January,2015,and they were randomly divided into control group and observation group. The observation group children received 1 μg / kg·h intravenous continuous infusion of dexmedetomidine,and the control group received the same amount of saline. The differences and adverse reactions of mean arterial pressure（ MAP）,heart rate（ HR）,the incidence of agitation（ EA）,children＇s anesthesia restlessness score（ PAED）,pain severity score（ CHEOPS） of two groups were compared. Results The MAP and HR of the observation group at each time had smaller change compared with the control group,and the EA incidence,PAED score and CHEOPS score at each time were significantly lower than children of the control group; the occurrence of adverse reactions in observation group was significantly lower than the control group. Conclusion Dexmedetomidine is better able to stabilize arterial pressure and heart rate during anesthesia in children,reduce children restlessness and incidence of postoperative incidence of adverse reactions during sevoflurane anesthesia,so it is worth clinical application.