新生儿消化道畸形手术以右美托咪定麻醉的效果分析

Analysis of effect of dexmedetomidine on neonatal digestive tract malformation

目的 探讨右美托咪定用于新生儿消化道畸形手术的麻醉效果。方法 将本院2015年10月至2017年10月收治的69例新生儿消化道畸形手术患者随机分为对照组(34例)与观察组(35例)。两组分别应用瑞芬太尼和右美托咪定进行麻醉,对比两组麻醉前后的血流动力学变化,以及术后镇静、镇痛效果。结果 观察组术后2、4、6、24 h的FLACC评分分别为(2.93±1.82)、(2.33±1.23)、(1.60±0.62)、(1.27±0.52)分,均显著低于对照组(P<0.05)。观察组术后1 h的Ramsay评分为(3.36±2.36)分,显著高于对照组的(1.55±0.92)分,两组比较差异有统计学意义(P<0.05)。两组T1、T2时刻的HR、SBP、DBP值均较T0时刻显著降低,并且对照组的降幅更为明显(P<0.05);两组T3时刻的HR、SBP、DBP值较T1、T2时刻有所升高,但仍低于T0时刻;观察组T3时刻的HR、SBP、DBP值分别为(146.45±5.53)次/min、(67.55±11.51)mmHg、(41.41±8.24)mmHg,均显著高于对照组的(137.14±5.36)次/min、(61.33±10.93)mmHg、(37.26±6.59)mmHg(P<0.05)。结论 在新生儿消化道畸形手术麻醉中应用右美托咪定,能够较好地维持血流动力学的稳定性,镇痛、镇静效果好,且苏醒质量好,不良反应少。

Objective To investigate the anesthetic effect of dexmedetomidine for neonatal digestive tract malformation.Methods 69 cases of neonatal digestive tract malformation were randomly divided into control group(34 cases)and observation group(35 cases).Remifentanil and dexmedetomidine were used for anesthesia in the two groups respectively,and the hemodynamic changes before and after anesthesia were compared,as well as the effects of postoperative sedation and analgesia.Results The FLACC scores of the observation group at 2 h,4 h,6 h,and 24 h after operation were(2.93±1.82)points,(2.33±1.23)points,(1.60±0.62)points,and(1.27±0.52)points,respectively,which were all significantly lower than those of the control group(P<0.05).The Ramsay score at 1 hour after operation in the observation group was(3.36±2.36)points,which was significantly higher than that in the control group[(1.55±0.92)points](P<0.05).The HR,SBP,and DBP values of the two groups at T1 and T2 were significantly lower than those at T0,and the decrease range in the control group was more significant(P<0.05);the HR,SBP,and DBP values of the two groups at T3 were higher than those at T1 and T2,but still lower than those at T0;the HR,SBP and DBP values of the observation group at T3 respectively were(146.45±5.53)times/min,(67.55±11.51)mmHg,and(41.41±8.24)mmHg,which were significantly higher than those of the control group[(137.14±5.36)times/min,(61.33±10.93)mmHg,(37.26±6.59)mmHg](P<0.05).Conclusion The use of dexmedetomidine in neonatal digestive tract malformation anesthesia can maintain the stability of hemodynamics,with good analgesia and sedation effect,good resuscitation quality,and few adverse reactions