低剂量右美托咪定联合舒芬太尼在儿童全麻苏醒期的应用

Clinical application of dexmedetomidine combined with sufentanyl to the emergence agitation in pediatric postanesthesia care unit

目的观察低剂量右美托咪定联合舒芬太尼对儿童七氟烷全麻苏醒期躁动(EA)的影响。方法将60例择期行斜疝手术的患儿随机分为研究组和对照组,每组30例。研究组给予右美托咪定0.2μg/kg联合舒芬太尼0.15μg/kg,对照组给予舒芬太尼0.15μg/kg,记录患儿术后拨出喉罩进入麻醉后监测治疗室(PACU)15 min内的Aono评分、苏醒期躁动评分(PAED)及CHIPPS评分评价患儿躁动及疼痛程度。结果研究组患儿的Aono评分、PAED评分及CHIPPS评分均显著低于对照组,组间差异具有统计学意义(P<0.05)。与对照组相比,研究组患儿躁动、谵妄及疼痛的发生率均显著降低,差异具有统计学意义(P<0.05)。所有患儿在麻醉诱导和维持过程中均无呕吐、误吸、呼吸暂停和喉痉挛等不良反应发生。结论低剂量右美托咪定(0.2μg/kg)联合舒芬太尼(0.15μg/kg)可缓解儿童全麻后EA。

Objective To observe the effect of low-dose dexmedetomidin combined with sufentanyl on emergence agitation in pediatric after sevflurane anesthesia. Methods A total of 60 children undergoing elective inguinal hernia surgery were randomly divided into study group（n=30, dexmedetomidin 0.2 μg/kg combined with sufentanyl 0.15 μg/kg） and control group（n=30, sufentanyl 0.15 μg/kg）. Aono＇s four point scale, pediatric anesthesia emergence delirium（PAED） scale and children＇s and infants＇ postoperative pain scale（CHIPPS） were recorded after extubation in PACU. Results In study group, the Aono score, PAED score and CHIPPS score were significantly lower than those in control group（P〈0.05）. Compared with control group, the incidence of agitation, delirium and pain in study group were significantly lower（P〈0.05）. However, there were no adverse reactions such as vomiting, aspiration, apnea or laryngospasm occurred in all children during the induction and maintenance of anesthesia. Conclusion Low-dose dexmedetomidine（0.2 μg/kg） combined with sufentanyl（0.15 μg/kg） can reduce emergence agitation after general anaesthesia in children.