摘要
目的探讨右美托咪定在小儿纤维支气管检查及肺泡灌洗术中的应用效果。方法将60例择期行小儿纤维支气管镜检查及肺泡灌洗术的患儿随机分为观察组和对照组,各30例。2组患儿均采用全身麻醉,观察组手术前10 min给予右美托咪定,对照组则给予生理盐水。观察2组患儿的生命体征变化,记录2组患儿入室时(T 0)、手术开始时(T 1)、拔喉罩时(T 2)、拔喉罩后5 min(T 3)、拔喉罩后15 min(T 4)、拔喉罩后30 min(T 5)的平均动脉压(MAP)、心率(HR)和呼吸频率(RR),观察2组患儿手术时间、麻醉时间、手术结束停药至喉罩拔除时间、躁动评分和Ramsay镇静评分,同时记录喉痉挛、呛咳、恶心呕吐等围术期不良反应的发生情况。结果2组患儿T 1时点的HR和RR无显著差异(P>0.05);观察组T 2、T 3、T 4和T 5时点的MAP及HR显著低于对照组(P<0.05);2组患儿手术结束停药至喉罩拔除时间无显著差异(P>0.05);拔管后,观察组躁动评分和Ramsay镇静评分显著优于对照组(P<0.05);观察组苏醒期躁动者与躁动持续时间超过15 min者均显著少于对照组(P<0.05);2组不良反应发生率无显著差异(P>0.05)。结论将右美托咪定应用于小儿纤维支气管镜检查伴肺泡灌洗术,可提高术中及术后镇静效果,且不良反应少。
Objective To investigate the application effect of dexmedetomidine in pediatric fiberoptic bronchoscopy and alveolar lavage.Methods Sixty children electively undergoing bronchoscopy and alveolar lavage were randomly divided into observation group and control group,with 30 cases in each group.Children of both groups were given general anesthesia,the observation group was treated by dexmedetomidine,while the control group was given saline.The changes of vital signs of the two groups were observed.Mean blood pressure(MAP),heart rate(HR)and respiratory rate(RR)were recorded and analyzed at the time points of room entry(T 0),at the beginning of surgery(T 1),at time of laryngeal mask removal(T 2),at 5 min after laryngeal mask removal(T 3),at 15 min after laryngeal mask removal(T 4),and at 30 min after laryngeal mask removal(T 5).The operation time,anaesthesia time,duration from drug withdrawal to awakening,removal time of laryngeal mask,restlessness score and Ramsay sedative score were observed in the two groups.The perioperative adverse reactions such as laryngeal spasm,choking cough,nausea and vomiting were also recorded.Results There were no significant differences in HR and RR between the two groups(P>0.05).MAP and HR in the observation group at T 2,T 3 T 4 and T 5 were lower than those in the control group(P<0.05).There was no significant difference in duration from drug withdrawal after surgery conclusion to removal of laryngeal mask in two groups(P>0.05).After extubation,restlessness score and Ramsay sedation score in the observation group were better than that in the control group(P<0.05).In the observation group,the patients with restlessness and duration of restlessness lasting more than 15 minutes were HT significantly less than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine applied in pediatric fiberoptic bronchoscopy and alveolar lavage can improve sedative effect during and after surgery
作者
匡荣
赵乐怿
吴家麟
韩军
KUANG Rong;ZHAO Leyi;WU Jialin;HAN Jun(Department of Anesthesiology,Changzhou Children′s Hospital,Changzhou,Jiangsu,213000)
出处
《实用临床医药杂志》
CAS
2020年第10期88-91,共4页
Journal of Clinical Medicine in Practice
基金
江苏省常州市卫计委青年人才科技项目(QN201826)。
