摘要
目的观察丙泊酚、咪唑安定、右美托咪定预防小儿七氟烷麻醉苏醒期躁动的临床效果。方法选择行会阴、腹股沟区手术的患儿80例,随机分为4组,每组20例,丙泊酚组(P组)、咪唑安定组(M组)、右美托咪定组(D组)和盐水组(N组)。4组患儿均用七氟烷吸入诱导及维持,用0.3%罗哌卡因0.75ml/kg骶管阻滞有效。术毕前10minP组泵注丙泊酚1mg/kg;M组泵注咪唑安定0.05mg/kg;D组泵注右美托咪定0.5μg/(kg·h);N组泵注盐水5ml。术毕时停七氟烷。术后均送入PACU。观察苏醒期躁动的例数、躁动评分、苏醒时间、PACU停留时间、反复躁动例数。结果 P组和D组躁动例数、躁动评分与N组比较差异有统计学意义(P<0.01)。M组较N组躁动评分虽轻(P<0.01),但躁动例数比较差异无统计学意义(P>0.05)。D组的苏醒时间与N组比较,差异无统计学意义(P>0.05),短于P组和M组(P<0.01)。M组的苏醒时间长于N组(P<0.01)。P组的苏醒时间短于M组(P<0.01),但长于N组(P<0.01)。苏醒过程中,D组苏醒过程平顺。而P组和M组均出现反复躁动的情况;P组与D组相比差异有统计学意义(P<0.05)。P组和D组PACU停留时间短于M组(P<0.01)。结论右美托咪定预防小儿七氟烷麻醉苏醒期躁动效果确切,又不延长苏醒及PACU停留时间,能更好地预防苏醒期反复躁动。
Objective To observe the clinical effect of propofol,midazolam and dexmedetomidine to prevent agitation during pediatric sevoflurane anesthesia recovery.Methods Selected 80 children undergoing perineum,inguinalregion surgery.They were randomly divided into four groups,each group of 20 cases,propofol group (group P),midazolam group (group M),dexmedetomidine group (group D) and the saline group (group N).Four groups of patients are induced and maintained with sevoflurane.It was effective to sacral cana block with 0.3% ropivacaine 0.75 ml/kg.Ten minutes before the end of surgery;Group P pumps were injected propofol 1 mg/kg;Group M pumps were injected midazolam 0.05 mg/kg; Group D pumps were injected dexmedetomidine 0.5μg/(kg·h);Group N pumps were injected 5 ml saline water.Sevoflurane was removed when the surgery was over.All patients were sent to the PACU.Then the number of agitation cases,agitation score,recovery time,PACU residence time and the number of repeated agitation cases were observed.Results The indicate the number of agitation cases and agitation score were quite different between group P,group D and group N (P<0.01).Although the agitation score in group M was lower than that in group N ( P<0.01),there was no significant difference in the number of agitation cases (P>0.05).There was no significant difference in recovery time between group D and group N (P>0.05),which was shorter than that of group P and group M (P<0.01).The recovery time of group M was longer than that of group N (P<0.01).The recovery time of group P was shorter than that of group M (P<0.01),but longer than that of group N (P<0.01).As for revival process,the group D revives smoothly.Group P and group M revive with repeated agitation;Group P was quite different from group D ( P<0.05).The PACU residence time of group P and group D was shorter than that of group M (P<0.01).Conclusion The dexmedetomidine can prevent effectively agitation during pediatric sevoflurane anesthesia recovery and it does not prolong recovery time and PACU stay t
出处
《中国当代医药》
2013年第24期107-108,110,共3页
China Modern Medicine
