右美托咪定预防小儿全身麻醉苏醒期躁动的效果分析

Effect of dexmedetomidine on preventing agitation in recovery period of general anesthesia in children

目的探讨右美托咪定预防小儿全身麻醉苏醒期躁动的作用。方法收集2017年12月～2018年10月我院收治的需要在全身麻醉下行手术治疗的患儿86例作为研究对象,按麻醉方法将86例患儿进行分组,研究组43例,麻醉诱导后应用右美托咪定,对照组43例,麻醉诱导后给予生理盐水。比较两组手术时间、不同时间的心率、平均动脉压(MAP)、全身麻醉苏醒期躁动评分及呕吐、躁动发生率。结果研究组手术时间与对照组比较,差异无统计学意义(P>0.05)。研究组T2、T3心率明显低于对照组,两组比较,差异有统计学意义(P<0.05);研究组T2、T3、T4 MAP明显低于对照组,两组比较,差异有统计学意义(P<0.05);研究组苏醒期呕吐发生率与对照组比较更高,而躁动发生率与对照组比较更低,拔管时、苏醒时躁动评分与对照组比较更低,两组比较,差异有统计学意义(P<0.05)。结论应用右美托咪定可使患儿的心率、MAP更平稳,安全性更高,降低小儿全身麻醉苏醒期躁动发生率,减轻苏醒期躁动程度,建议在临床推广应用。

Objective To investigate the effect of dexmedetomidine on prevention of agitation in recovery period of general anesthesia in children.Methods Eighty-six children who underwent surgical treatment under general anesthesia in our hospital from December 2017 to October 2018 were enrolled and the children were divided according to methods of anesthesia.The 43 patients in the study group were given dexmedetomidine after induction of anesthesia and the 43 patients in the control group were given normal saline.The operation time,heart rate at different time,mean arterial pressure(MAP),the agitation score during general anesthesia recovery,and the incidence of vomiting and agitation were compared between the two groups.Results There was no significant difference in the operation time between the study group and the control group(P >0.05).The heart rates of T2 and T3 in the study group were significantly lower than those in the control group,and there was significant difference between the two groups(P<0.05).The MAPs of T2,T3 and T4 in the study group were significantly lower than those in the control group,and there was significant difference between the two groups(P<0.05).The incidence of vomiting during recovery in the study group was higher than that in the control group,and the incidence of agitation was lower than that in the control group.The agitation scores at the time of extubation and recovery were lower than those of the control group,and there was a significant difference between the two groups(P<0.05).Conclusion The application of dexmedetomidine can stabilize the heart rate and MAP of patients,and it has higher safety.It can also reduce the incidence of agitation during the recovery period of general anesthesia in children and reduce the degree of agitation during the recovery period,thus it is recommended to be applied in clinic.