论文部分内容阅读
目的观察右美托咪定预防小儿神经外科手术全麻苏醒期躁动的临床效果。方法选择天津市环湖医院2013年1—11月择期行幕上脑肿瘤切除术的40例患儿,采用随机数字表法将其分成右美托咪定组(Dex组)和0.9%氯化钠溶液组(NS组),各20例。Dex组在脑膜缝合完毕后给予右美托咪定0.5μg/kg,NS组给予同等剂量的0.9%氯化钠溶液,观察两组给药前(T0)、给药后(T1)、拔除气管插管时(T2)、拔管后5min(T3)的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)的变化,以及拔管时间和躁动发生情况。结果两组患儿T0的MAP、HR比较,差异无统计学意义(P>0.05);两组T1的HR比较,差异有统计学意义(P<0.05);两组患儿T2、T3的MAP、HR比较,差异有统计学意义(P<0.05)。Dex组苏醒期的躁动评分优于NS组,差异有统计学意义(P<0.05);Dex组苏醒期躁动率为5%,低于NS组的30%,差异有统计学意义(P<0.05)。Dex组自主呼吸恢复时间、拔管时间短于NS组,差异有统计学意义(P<0.05)。结论右美托咪定在小儿气管插管术全麻中可以发挥较好的镇静、镇痛、稳定血流动力学的效果,同时还能有效降低术后躁动等发生率。
Objective To observe the clinical effect of dexmedetomidine in preventing agitation of pediatric neurosurgical general anesthesia during wakefulness. Methods Forty children with elective brain tumor resection from January to November 2013 in Tianjin Huanhu Hospital were divided into three groups: dexmedetomidine group (Dex) and 0.9% chlorinated Sodium solution group (NS group), each 20 cases. Dex group was given dexmedetomidine 0.5μg / kg after suture of meningeal membrane, NS group was given the same dose of 0.9% sodium chloride solution, the two groups before administration (T0), after administration (T1) The mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR) during intubation (T2), 5 min after extubation (T3), as well as extubation time and agitation. Results There was no significant difference in T0 MAP and HR between the two groups (P> 0.05). There was significant difference in HR between T1 and T2 (P <0.05) , HR, the difference was statistically significant (P <0.05). The restlessness score of Dex group was better than that of NS group (P <0.05), the restlessness rate of Dex group was 5%, which was lower than that of NS group (P <0.05) ). Dex group spontaneous breathing recovery time, extubation time was shorter than NS group, the difference was statistically significant (P <0.05). Conclusion Dexmedetomidine can exert better effects on sedation, analgesia and hemodynamics during general anesthesia of pediatric tracheal intubation, and can effectively reduce the incidence of postoperative agitation.