摘要
目的评价右美托咪定在小儿全身麻醉苏醒期躁动防治中的应用价值。方法将120例择期行骨科手术的患儿随机分入右美托咪定0.4μg/kg组、右美托咪定0.2μg/kg组、丙泊酚1mg/kg组、0.9%氯化钠溶液组,每组30例。右美托咪定0.4μg/kg组、右美托咪定0.2μg/kg组和0.9%氯化钠溶液组分别于手术结束前经静脉输液泵注射相应药物10min,丙泊酚1mg/kg组于手术结束时经静脉输液泵注射丙泊酚。4组的药物容积均为10mL。小儿苏醒期躁动评分采用Aono的四分评级法和儿童麻醉苏醒谵妄(PAED)评分,记录拔除气管导管后15min时的Aono评分、PAED评分和躁动发生率。结果右美托咪定0.4μg/kg组的Aono评分、PAED评分、躁动发生率均显著低于右美托咪定0.2μg/kg组、丙泊酚1mg/kg组和0.9%氯化钠溶液组(P值均<0.05),但后3组间的差异均无统计学意义(P值均>0.05)。所有患儿在麻醉诱导和维持中均无呕吐、误吸、呼吸暂停和喉痉挛等不良反应发生。结论手术结束前10min给予右美托咪定0.4μg/kg能够降低小儿苏醒期的术后躁动率。
Objective To evaluate the effect of dexmedetomidine （Dex） on emergence agitation in children after general anesthesia. Methods A total of 120 pediatric patients undergoing elective orthopedic operation were randomly divided into four groups （n = 30）. Dex 0.4 μg/kg, Dex 0.2 μg/kg and 0.9% sodium chloride solution were continuously infused by venous pump for 10 min before the end of the surgery. Propofol 1 mg/kg was bolus intravenously after the end of the surgery. The drugs were diluted to 10 mL normal saline. Aono＇s Four Point Scale and Pediatric Anesthesia Emergence Delirium （PAED） Scale were used to evaluate the emergence agitation. Aono scores, PAED scores and the incidence of agitation were recorded 15 min after extubation. Results Aono scores, PAED scores and the incidence of agitation in Dex 0.4 ~g/kg group were significantly lower than those in Dex 0.2 μg/kg group, propofol 1 mg/kg group and saline group （all P〈0.05）. There were no significant differences between Dex 0.2 μg/kg group, propofol 1 mg/kg group and saline group （all P〉0. 05）. No adverse reactions such as vomiting, aspiration, apnea or laryngospasm occurred in all children during the induction and maintenance of anesthesia. Conclusion The administration of Dex 0.4 μg/kg at 10 min before the end of operation can decrease the incidence of emergence agitation in children. （Shanghai Med J, 2013, 36： 680-682）
出处
《上海医学》
CAS
CSCD
北大核心
2013年第8期680-682,共3页
Shanghai Medical Journal
关键词
右美托咪啶
苏醒期躁动
丙泊酚
小儿
Dexmedetomidine
Emergence agitation
Propofol
Children
