右美托咪定与七氟醚用于小儿困难气道麻醉诱导中作用研究

Effect of dexmedetomidine and sevoflurane in the induction of difficult airway anesthesia in children

目的探讨右美托咪定联合七氟醚用于小儿困难气道麻醉诱导中的临床效果和安全性。方法选择经麻醉前评估为困难气道患儿53例,随机分为观察组26例和对照组27例,分别采用右美托咪定联合七氟醚和单纯七氟醚麻醉的方法,诱导5 min后利用纤维支气管镜引导经鼻进行气管插管,比较2组患儿的血流动力学指标、麻醉结果和手术结果。结果观察组患者的HR在T1、T2以及T3与对照组比较明显降低(P<0.05)。观察组患者的MAP在T2和T3与对照组比较明显升高(P<0.05)。2组患儿的SpO2和RR无明显差异(均P>0.05)。对照组的不良反应发生率明显高于观察组(P<0.05)。结论右美托咪定联合七氟醚用于小儿困难气道麻醉诱导效果良好。

Objective To investigate the clinical efficacy and safety of dexmedetomidine combined with sevoflurane in the induction of difficult airway anesthesia in children.Methods A total of 53 children with difficult airway assessment before anesthesia in our hospital from January 2015 to May 2018 were enrolled in this study.They were randomly divided into observation group(n=26)and control group(n=27).The dexmedetomidine combined with sevoflurane and sevoflurane alone were used,respectively.After 5 minutes of induction,tracheal intubation was performed by fiberoptic bronchoscopy.The hemodynamic parameters,anesthesia results and surgical outcomes of the two groups were recorded compared.Results The HR of the observation group was significantly lower than those of the control group at T1,T2 and T3.And the differences were statistically significant(all P<0.05).The MAP of the observation group was significantly higher in the T2 and T3 those of the control group.And the differences were statistically significant(all P<0.05).There was no significant difference in SpO2 and RR between the two groups(all P>0.05).The incidence of adverse reactions in the control group was significantly higher than that in the observation group(P<0.05).Conclusion Dexmedetomidine combined with sevoflurane is effective in the induction of difficult airway anesthesia in children.It is worthy of clinical application.