右美托咪定与丙泊酚用于小儿气管异物取出术的麻醉效果比较

Comparison between dexmedetomidine and propofol on children undergoing removal of tracheal foreign body

目的比较右美托咪定与丙泊酚分别用于小儿气管异物取出术的麻醉效果及安全性。方法气管异物取出术患儿40例,呼吸困难评级为(2-3)级,采用随机数字表法分为2组(n=20),术中A组用右美托咪定0.3μg·kg-1·h-1持续泵入,B组用丙泊酚(4-10)mg·kg-1·h-1维持。术中保留患儿自主呼吸,给予高频射流呼吸机供氧。分别记录硬性支气管镜置入时,拔管时,拔管后1min,拔管后5min的HR,RR,MAP,SPO2,术中发生呛咳例数以及根据Steward苏醒评分表进行评估。结果 A组HR,MAP,术中呛咳例数,SPO2<80%的例数及苏醒时间低于B组,RR高于B组(P<0.05)。结论右美托咪定在小儿支气管镜异物取出术中副作用少,呼吸、循环系统维持相对稳定,其效果优于丙泊酚。

Objective To compare the effects and safety between dexmedetomidine and propofol on children undergoing tracheobronchial foreign body removal surgery. Methods 40 childern undergoing tracheobronchial foreign body removal surgery, dyspnea grade were 2 to 3 Digital random table method were utilized for dividing them into two groups.（n=20 each）：dexmedetomidine group（group A） and propofol group（group B）.In group A,anesthesia was maintained by receiving infusion of dexmedetomidine 0.3μg·kg-1·h-1,while group B receiving intravenoous infusion of propofol 4-10mg·kg-1·h-1.In the surgery,both children group maintained spontaneous breathing,oxygern was offered by high-frequency jet ventilator.HR,RR,MAP,SPO2 and numbers of coughing were recorded during and after operation,included the time rigid bronchoscope was in the trachea,extubaton,1 min after extubation and 5 min after extubation,as well as Steward recovery score were recorded. Results Compared with group B,HR,MAP,the numbers of coughing,the numbers of SPO2〈80% and recovery scores were lower in group A,while RR in group A were higher than that of group B（P〈0.05）. Conclusion The application of dexmedetomidine in tracheobronchial foreign body removal surgery has a less postoperative complicatons,and it makes respiratory system and hemodynamic parameters more stable,which can enhance the quality of general anesthesia efficiently.