右美托咪定对扁桃体及腺样体切除术患儿麻醉苏醒期的作用

Effect of dexmedetomidine on tonsillectomy and adenoidectomy children in anesthesia recovery period

目的研究右美托咪定对扁桃体及腺样体切除术患儿七氟醚复合麻醉苏醒期噪动的影响。方法选取拟在全身麻醉气管插管下行扁桃体及腺样体切除手术的患儿80例,将其随机分为观察组和对照组,每组各40例。全部患者都静脉注射芬太尼2μg/kg,异丙酚3 mg/kg完成诱导插入气管插管,手术过程中为患者吸入2%~3.5%七氟醚以维持麻醉效果。观察组插入气管插管后,静脉注射右美托咪定0.2μg/(kg·h),对照组则输注等剂量的氯化钠注射液,比较两组麻醉苏醒期噪动的影响。结果观察组的PAED评分(8.0±1.5)明显低于对照组的(11.9±1.7),且差异有统计学意义(P<0.05)。观察组的躁动发生率、不良反应发生率均明显低于对照组,且差异均有统计学意义(P<0.05)。观察组的麻醉恢复室PACU停留时间明显低于对照组的,且差异有统计学意义(P<0.05)。观察组的手术时间、拔管时间与对照组的比较,差异均未见统计学意义(P<0.05)。结论使用右美托咪定有助于减少患儿苏醒期躁动,帮助患儿平稳度过麻醉苏醒期,并减少术后的不良反应,值得临床进一步推广运用。

Objective To study the effect of dexmedetomidine on the recovery period of sevoflurane combined anesthesia on children underwent tonsillectomy. Methods Eighty children with tonsil and adenoid body resection done under general anestheia and endotnicheal intubation were randomly divided into observation group and control group,with 40 cases in each group. All of the patients were given intravenous fentanyl 2 g/kg,propofol 3 mg/kg induced complete insertion ofendotracheal intubation,during the surgical procedures,the patients were treated with inhalation 2%-3. 5% sevoflurane to maintain anesthesia. The patients in the observation group were intubated and were infused with dexmedetomidine,0. 2 g/（ kg·h）,while the control group was infused with the same dose of saline. The effects of anesthesia during the recovery period of the two groups were compared. Results The PAED score of the observation group（ 8. 0 ± 1. 5） was significantly lower than that of the control group（ 11. 9 ± 1. 7）,and the difference was significant（ P〈0. 05）. The incidences of agitation and adverse reactions in the observation group were significantly lower than those in the control group,and the differences were significant（ P〈0. 05）. The PACU residence time of the observation group was significantly lower than that of the control group,and the difference was significant（ P〈0. 05）. There was no significant difference in the operation time or extubation time between the observation group and the control group（ P〈0. 05）. Conclusions Dexmedetomidine can help to reduce the recovery period of restlessness in children,and help children to live through the recovery period of anesthesia,and reduce postoperative adverse reactions,which is worthy of further clinical application.