丙泊酚联合右美托咪定静脉麻醉在小儿先天性心脏病手术中的应用效果

Application effect of propofol combined with dexmedetomidine intravenous anesthesia in children undergoing surgery of congenital heart disease

目的探讨丙泊酚联合右美托咪定静脉麻醉在先天性心脏病(CHD)手术患儿中的应用效果。方法抽取2020年2月至2021年2月于河南省儿童医院行丙泊酚静脉麻醉的50例CHD手术患儿纳入对照组;抽取同期行丙泊酚联合右美托咪定静脉麻醉的50例CHD手术患儿纳入研究组;查阅患儿病历资料,记录并比较两组患儿麻醉前(T0)、麻醉30 min(T1)、体外循环结束时(T2)、术毕时(T3)心率、平均动脉压;记录患儿苏醒时间、苏醒期躁动量化评分(PAED);统计患儿麻醉不良反应情况。结果两组患儿T1~T2时点心率、平均动脉压降低,T3时点回升,且研究组T1~T3时点心率、平均动脉压高于对照组(P<0.05);研究组患儿苏醒时间、PAED评分低于对照组(P<0.05);两组麻醉不良反应总发生率比较差异未见统计学意义(P>0.05)。结论丙泊酚联合右美托咪定静脉麻醉有利于维持CHD手术患儿术中血流动力学稳定,促进患儿术后苏醒,减少苏醒期躁动,且安全性好。

Objective To observe the effect of propofol combined with dexmedetomidine intravenous anesthesia in children undergoing surgery of congenital heart disease(CHD).Methods Fifty children with CHD undergoing intravenous anesthesia with propofol in Henan children’s Hospital from February 2020 to February 2021 were included in the control group;the 50 children with CHD undergoing intravenous anesthesia with propofol and dexmedetomidine were collected and included in the study group.The medical records of the children were reviewed,and the heart rate and mean arterial pressure before anesthesia(T0),30 minutes after anesthesia(T1),at the end of cardiopulmonary bypass(T2)and at the end of operation(T3)were recorded and compared between the two groups;the recovery time and quantitative restlessness score(PAED)were recorded;the adverse effects of anesthesia in children were counted.Results The snack rate and mean arterial pressure decreased at T1-T2 and increased at T3,and the snack rate and mean arterial pressure at T1-T3 in the study group were higher than those in the control group(P<0.05);the recovery time and paed score of children in the study group were lower than those in the control group(P<0.05);there was no significant difference in the total incidence of adverse anesthetic reactions between the two groups(P>0.05).Conclusions Propofol combined with dexmedetomidine intravenous anesthesia is helpful to maintain the stability of hemodynamics in children with CHD,promote the recovery of children after operation,reduce the agitation in the recovery period,and has good safety.