摘要
目的探讨小儿腹腔镜疝气手术,在围术期不同时间点给予一定剂量的右美托咪定(DEX)对术前患儿分离焦虑及术后躁动的影响,来评估患儿围术期的舒适化程度。方法腹腔镜双侧疝囊高位结扎术的患儿90例,随机分为3组(每组30例):对照组(C组),DEX处理1组(Y1组),DEX处理2组(Y2组)。手术开始前30 min,各组分别经静脉给予长托宁0.01 mg/kg、生理盐水10 mL,Y1及Y2组静脉泵入DEX 1μg/kg,其中Y2组在完成气管插管后经微量泵追加DEX 0.2μg/kg。观察各组患儿入手术时与父母分离的满意例数;拔管期的躁动例数以及在术后恢复室(PACU)的停留时间。结果与C组比较,Y1组和Y2组患儿与父母分离满意例数明显增多,拔管期的躁动例数明显减少,PACU的停留时间明显缩短(P<0.05)。与Y1组比较,Y2组患儿与父母分离满意例数无明显差别(P>0.05);而在拔管期的躁动例数减少及在PACU的停留时间明显缩短(P<0.05)。结论在手术开始前30 min,给予DEX 1μg/kg静脉输注,并在插管完成后追加DEX 0.2μg/kg,患儿能较好的避免分离焦虑,术后躁动发生较少,也缩短了PACU的停留时间,有效地提高了患儿围术期的舒适度。
Objective To investigate the effect of dexmedetomidine(DEX)administrated at different time of pediatric laparoscopic hernia surgery during the perioperative period on the separation anxiety and postoperative agitation and to evaluate the degree of comfortable feelings during the operation.Methods Ninety patients with laparoscopic bilateral hernia sac high ligation were randomly divided into 3 groups(30 patients in each group):group C,group Y1,and group Y2.Each group was given intravenous saline 10 mL,DEX 1μg/kg,and DEX 1μg/kg(slowly instilled)respectively 30 minutes before the operation.The Y2 group was given a DEX of 0.2μg/kg via the intravenous pumping after completion of the tracheal intubation.Then record the number of satisfactory cases separated from the parents at the time before anesthesia induction in each group;and observe the number of twitches during extubation period and the stay time in the PACU.Results Compared with group C,the number of satisfactory patients with Y1 group and Y2 group was significantly increased.The number of agitation in the extubation period was significantly reduced,and the retention time of PACU was significantly shorter(P<0.05).Compared with the Y1 group,there was no significant difference between the Y2 group on Separation anxiety.The number of agitation in the extubation period were reduced and the staying time in the PACU were significantly shorter(P<0.05).Conclusions Infusion of DEX 1μg/kg 30 minutes before the start of surgery and administrate the addition of DEX 0.2μg/kg after the intubation,the child could avoid separation anxiety,and the postoperative agitation would be reduced and the residence time of the PACU would be shorter.And that could effectively improve the comfortable to the child at the perioperative period.
作者
郑文忠
李长红
袁小芳
颜学滔
Zheng Wenzhong;Li Changhong;Yuan Xiaofang;Yan Xuetao(Department of Anesthesiology,Baoan Maternal and Child Health Hospital,Jinan University,Shenzhen 518100,China)
出处
《湖北民族学院学报（医学版）》
2019年第4期7-10,共4页
Journal of Hubei Minzu University(Medical Edition)
基金
深圳市宝安区2017科研立项(2017JD153)
关键词
右美托咪定
分离焦虑
术后躁动
舒适化麻醉
dexmedetomidine
separation anxiety
postoperative agitation
comfort anesthesia
