摘要
目的探讨不同剂量右美托咪定用于小儿扁桃体手术围术期麻醉预防术后躁动的效果。方法选取医院2017年4月至2019年4月收治拟行扁桃体手术的患儿129例,随机分为右美托咪定低剂量组(A组)、右美托咪定高剂量组(B组)、对照组(C组),各43例。3组患儿均予全身静脉麻醉,A组、B组患儿分别于麻醉诱导前静脉泵注0.2,0.4μg/kg盐酸右美托咪定注射液,C组患儿泵注等量0.9%氯化钠注射液,然后进行手术。结果B组患儿自主呼吸恢复时间、睁眼时间、拔管时间、肌力恢复时间均明显长于A组、C组(P<0.05);A组、B组患儿躁动量表评分、视觉模拟评分均明显低于C组,Ramsay镇静评分及术后简易智能精神状态检查量表评分、蒙特利尔认知评估量表评分均明显高于C组(P<0.05);A组、B组、C组不良反应发生率相当(P>0.05)。结论右美托咪定用于小儿扁桃体手术麻醉,可明显减轻患儿的躁动程度,改善术后认知功能,且不会明显增加不良反应。小剂量应用即可起效,不影响麻醉苏醒时间;大剂量应用时躁动抑制效果并未明显增强,反而会延长麻醉苏醒时间。
Objective To investigate the effect of different doses of dexmedetomidine on perioperative anesthesia of children undergoing tonsillectomy for the prevention of postoperative restlessness.Methods A total of 129 children undergoing tonsillectomy in the hospital from April 2017 to April 2019 were selected and randomly divided into the dexmedetomidine low dose group(group A),dexmedetomidine high dose group(group B)and control group(group C),43 cases in each group.The three groups were given general intravenous anesthesia;group A and group B were given intravenous pump of 0.2μg/kg and 0.4μg/kg of dexmedetomidine before induction of anesthesia,and group C was given the same amount of 0.9%sodium chloride injection before operation.Results The recovery time,spontaneous breathing time,extubation time,and muscle strength recovery time of group B were significantly longer than those in groups A and C(P<0.05);the scores of agitation scale and visual analogue scale(VAS)in groups A and B were significantly lower than those in group C,and their scores of Ramsay Sedation,post-operative Mini-Mental Sate Examination(MMSE),and Montreal Cognitive Assessment Scale(MoCA)were significantly higher than those in group C(P<0.05).The incidence of adverse reactions in groups A,B,and C was comparable(P>0.05).Conclusion Dexmedetomidine on perioperative anesthesia of children undergoing tonsillectomy can significantly reduce the restlessness of children and improve their cognitive function after operation without obvious increase of adverse reactions.The application of low dose of dexmedetomidine can be effective without affecting the anesthesia recovery time,while the effect of restlessness inhibition at high dose is not significantly enhanced,and the recovery time of anesthesia in children is prolonged.
作者
张辉
彭晓静
鄂慧良
李金秋
蔡立松
郭平选
ZHANG Hui;PENG Xiaojing;E Huiliang;LI Jinqiu;CAI Lisong;GUO Pingxuan(Department of Anesthesia,Kailuan General Hospital,Tangshan,Hebei,China 063000)
出处
《中国药业》
CAS
2020年第14期59-61,共3页
China Pharmaceuticals
基金
河北省医学科学研究重点课题[20181434]。
关键词
小儿
扁桃体手术
围术期
麻醉效果
右美托咪定
术后躁动
剂量
认知功能
children
tonsillectomy
perioperative period
anesthetic effect
dexmedetomidine
postoperative restlessness
dose
cognitive function
