盐酸右美托咪定对小儿扁桃体/腺样体切除术中应激反应的影响

Effect of dexmetidine hydrochloride on stress response during tonsillectomy in children

目的探讨盐酸右美托咪定对小儿扁桃体及腺样体切除术中应激反应的影响。方法选取接受扁桃体及腺样体切除术的40例患儿作为研究对象,按入院时间分为对照组和观察组,各20例。对照组采用常规麻醉和等量生理盐水,观察组在对照组的基础上采用盐酸右美托咪定。比较两组患儿术中麻醉前3 min(T_1)、气管插管前3 min(T_2)、气管插管后3 min(T_3)、手术结束10 min(T_4)和拔管后10 min(T_5)的平均动脉压(MAP)和心率(HR),比较两组麻醉后的血糖(GLU)、皮质醇(COR)和肾上腺素(E)浓度及两组的手术时间、麻醉时间、麻醉苏醒时间和拔管时间。结果对照组T_2、T_3、T_4、T_5中MAP、HR均高于观察组具有统计学意义(P<0.05);对照组的血糖、肾上腺素与皮质醇水平均高于观察组具有统计学意义(P<0.05);对照组的麻醉苏醒时间和拔管时间比观察组长,两组比较有统计学意义(P<0.05)。结论盐酸右美托咪定具有镇痛、镇静作用,在小儿扁桃体及腺样体切除术中,有很好的麻醉辅助效果,减少术中患儿的应激反应和麻醉药量的使用。

Objective To investigate the effect of dexmetidine hydrochloride on stress response in tonsillectomy and adenoidectomy in children.Methods Forty children undergoing tonsillectomy and adenoidectomy were divided into control group(n=20)and observation group(n=20).The observation group was treated with dexmetidine hydrochloride on the basis of the control group.The mean arterial pressure(MAPP)and heart rate(HRT)were compared between the two groups before anesthesia 3 min before anesthesia,3 min before tracheal intubation,3 min after tracheal intubation,3 min after tracheal intubation,10 min after operation and 10 min after extubation.After anesthesia,the concentrations of GLU,Corco and epinephrine,and the operation time of the two groups,Anesthesia time,anaesthesia recovery time and extubation time.Results The levels of blood glucose,adrenaline and cortisol in the control group were significantly higher than those in the observation group(P<0.05),and the recovery time and extubation time of anesthesia in the control group were significantly higher than those in the observation group(P<0.05),and the levels of blood glucose,adrenaline and cortisol in the control group were significantly higher than those in the observation group(P<0.05).There was significant difference between the two groups(P<0.05).Conclusion Dexmetomide hydrochloride has analgesic and sedative effects.It has a good anaesthesia effect in tonsillectomy and adenoidectomy,and reduces stress reaction and anesthetic dosage in children during operation.