右美托咪定复合舒芬太尼在儿童纤维结肠镜检查中的应用

The application of sufentanil combined with dexmedetomidine in children with colonscopy

目的观察右美托咪定复合舒芬太尼在儿童纤维结肠镜检查中的麻醉效果及安全性。方法选择行纤维结肠镜检查的患儿40例，ASAⅠ或Ⅱ级，年龄10～15岁。随机分为右美托眯定复合舒芬太尼组（D组）和丙泊酚复合舒芬太尼组（P组），每组20例。两组均先静脉注射舒芬太尼0．1μg／kg后，D组10min内泵人右美托咪定1μg/kg，再持续泵入右美托咪定1μg·kg^-1·h^-1。P组静脉注射丙泊酚2mg／kg后，持续泵人丙泊酚6mg·kg^-1·h^-1。对两组麻醉效果进行评级，观察两组给药前（T0）、给药10min后（T1）、入肛门时（T2）、至回盲部时（T3）HR、MAP和SpO2的变化，记录苏醒时间及麻醉后不良反应情况。结果D组麻醉效果优于P组（P〈0．05）。T1时两组HR、MAP均明显低于T0（P〈0．05），P组SpO2在T1、T2、T3时明显低于D组和T0（P〈0．05）。T2、T3时D组HR慢于P组和T0（P〈0．05）。P组苏醒时间长于D组（P〈0．05）。P组术中舌后坠和呼吸抑制的发生率明显高于D组（P〈0．05）。结论右美托咪定复合舒芬太尼用于儿童纤维结肠镜检查较安全，且麻醉效果满意。

Objetive To observe the effect and safety of using sufentanil with dexmedetomidine in colonoscopy in children. Methods Forty children （ASA Ⅰ or Ⅱ, aged 10 - 15 years） undergoing colonscopy were randomly devided into two groups, with 20 children in each. Group D were injected sufentanil with dexmedetomidine and group P were injected propofol with dexmedetomidine. The scale of anesthetic effect, HR, MAP, and SpO2 at pre-injection（TO ）, 10 min after injection （T1）, when colonoscopy was put into the anus （ T2 ）, when colonoscopy was put to the ileocecal junction （ T3 ） were documented. The time of recovery and complication after anesthesia were recorded. Results The anesthetic effect in group D was better than in group P（ P 〈 0.05 ）. In two groups, HR, MAP at T1 were lower than at To （ P 〈 0.05 ）. In group P, SpO2 at T1 ,T2 ,T3 were lower than in group D and at T0（P 〈0.05）. In group D, HR at T2 ,T3 were lower than in group P and at To （ P 〈 0.05 ）. The time of recovery in group P was longer than that in group D （ P 〈 0.05 ）. The Complication of glossocoma and respiratory depression in group P was higher than in group D （ P 〈 0.05 ）. Conclusions The anesthetic effect of dexmedetomidine combined with sufentanil in children undergoing colonscopy is satisfactory and safe.