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不同剂量右美托咪定对OSAHS腭咽成形术患儿苏醒期躁动及血流动力学的影响 被引量:2

Comparison on Effects of Different Doses of Dexmedetomidine on Emergency Agitation and Hemodynamics in Children with OSAHS after Palatopharyngoplasty
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摘要 目的:探讨不同剂量右美托咪定对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)腭咽成形术患儿苏醒期躁动及血流动力学的影响。方法:选取2019年1月至2021年8月接受腭咽成形术治疗的100例OSAHS患儿,采用随机数表法分为A组(33例)、B组(33例)和C组(34例)。三组患儿均采用全身麻醉,于麻醉诱导前,A组给予0.2μg/kg右美托咪定,B组给予0.4μg/kg右美托咪定,C组给予0.6μg/kg右美托咪定。采用广义估计方程分析两组患儿入室时(T0)、泵注10 min时(T1)、拔管时(T2)、苏醒时(T3)的血流动力学[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)]相关指标,比较三组患儿苏醒期相关情况。结果:基于广义估计方程分析,结果显示,T1时三组患儿HR水平均较T0时升高,但在T2时回降,且趋于平稳,但三组患儿各时点之间比较差异无统计学意义(P>0.05);三组患儿MAP、SpO2水平先降后升,但三组患儿各时点之间比较差异无统计学意义(P>0.05);C组的苏醒时间和拔管时间均长于A组和B组,B组、C组的儿童麻醉苏醒期躁动量表评分均低于A组(P<0.01),但A组和B组的苏醒时间和拔管时间比较、B组和C组的PAED评分比较,差异无统计学意义(P>0.05)。结论:不同剂量的右美托咪定均可维持OSAHS腭咽成形术患儿的血流动力学稳定,无剂量相关性,但0.4μg/kg右美托咪定可有效降低患儿术后躁动发生风险,且患儿呼吸和意识恢复更快。 Objective:To investigate the effects of different doses of dexmedetomidine on emergence agitation and hemodynamics in children with obstructive sleep apnea-hypopnea syndrome(OSAHS)after palatopharyngoplasty.Methods:A total of 100 children with OSAHS who underwent palatopharyngoplasty in the hospital from January 2019 to August 2021 were selected.They were randomized into group A(33 cases),group B(33 cases)and group C(34 cases).General anesthesia was used in all three groups of children.Before anesthesia induction,group A was given 0.2μg/kg dexmedetomidine,group B was given 0.4μg/kg dexmedetomidine,and group C was given 0.6μg/kg dexmedetomidine.The mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO2)at the time of entering the room(T0),10 minutes of pumping(T1),extubating(T2)and recovery(T3)between the two groups were analyzed by generalized estimation equation,and the correlation among the three groups during the recovery period was compared.Results:Based on the analysis of generalized estimation equation,the results showed that,at T1,the HR levels of the three groups increased than those at T0,but decreased back at T2and tended to be stable,without statistically significant difference in terms of comparison among the three groups at each time point(P>0.05);the levels of MAP and SpO2in the three groups decreased at first and then increased,without significant difference(P>0.05);the recovery time and extubating time of group C were longer than those of group A and group B,and the Pediatric Anesthesia Emergence Delirium Scale(PAED)scores of group B and group C were lower than those of group A(P<0.01),but there was no statistically significant difference in the comparison of the recovery time and extubating time between group A and group B,either in the comparison of PAED scores between group B and group C(P>0.05).Conclusion:Different doses of dexmedetomidine can maintain hemodynamic stability in children with OSAHS after palatopharyngoplasty without dose correlation.However,0.4μg/kg dexme
作者 孔建强 汪琼 汪建胜 Kong Jianqiang;Wang Qiong;Wang Jiansheng(Shanghai Baoshan Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Shanghai 201999,China)
出处 《儿科药学杂志》 CAS 2023年第2期50-54,共5页 Journal of Pediatric Pharmacy
关键词 阻塞性睡眠呼吸暂停低通气综合征 腭咽成形术 右美托咪定 血流动力学 苏醒期躁动 obstructive sleep apnea-hypopnea syndrome palatopharyngoplasty dexmedetomidine hemodynamics emergence agitation
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