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目的观察喉罩吸入全麻诱导前应用右美托咪啶对会阴型尿道下裂手术患儿麻醉深度及苏醒质量的影响。方法择期行会阴型尿道下裂手术男性患儿40例,随机分成右美托咪啶组(D组)和对照组(C组)。D组给予右美托咪啶负荷剂量1μg/kg,10 min注射完毕,术中以0.5μg/(kg·h)维持输注;C组静脉输注相同剂量生理盐水,之后静脉全麻诱导,行喉罩吸入全麻。记录给药前(T0),诱导后置入喉罩前(T1),置入喉罩后1 min(T2)、5min(T3),手术结束时(T4),清醒睁眼时(T5),拔出喉罩后1 min(T6)、5 min(T7)、10 min(T8)患儿的心率(HR)、收缩压(SBP)、舒张压(DBP)。并记录患儿停药至清醒睁眼时间、拔出喉罩时间及不良反应。结果两组HR、SBP及DBP在T1、T2、T3、T4时点差异无统计学意义。与C组相比,D组SBP、DBP及HR在T5、T6时点下降,且停药至清醒睁眼时间、拔出喉罩时间缩短(P均<0.05)。两组均未见严重不良反应。结论喉罩吸入全麻诱导前应用右美托咪啶可减少拔管反应和苏醒期不良反应,提高围术期血流动力学稳定性,使喉罩全麻会阴型尿道下裂手术患儿麻醉镇静深度适当。
Objective To observe the effects of dexmedetomidine on the anesthetic depth and wakefulness of children with episiotomy of hypospadias treated with laryngeal mask inhalation before general anesthesia induction. Methods Forty male patients with hypospadias genital hypospadias were randomly divided into dexmedetomidine group (D group) and control group (C group). Group D was given dexmedetomidine loading dose 1μg / kg, 10min injection was completed, 0.5μg / (kg · h) intraoperative infusion; Group C intravenous infusion of the same dose of saline, followed by intravenous anesthesia induction, Laryngeal mask inhalation anesthesia. (T0), before induction of laryngeal mask (T1), 1 min (T2), 5 min (T3) after laryngeal mask placement, T4 at the end of surgery, Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at 1 min (T6), 5 min (T7) and 10 min (T8) And recorded children with withdrawal until awake eyes open time, pull out laryngeal mask time and adverse reactions. Results There was no significant difference in HR, SBP and DBP between the two groups at T1, T2, T3 and T4. Compared with group C, the SBP, DBP and HR of group D decreased at T5 and T6, and the duration of withdrawal to sober eye opening was shorter than that of group C (P <0.05). No serious adverse reactions were seen in both groups. Conclusion The application of dexmedetomidine before induction of general anesthesia with laryngeal mask can reduce the extubation and awakening adverse reactions, improve the hemodynamic stability during perioperative period and anesthesia in children undergoing general anesthesia for perineal episiotomy of hypospadias Calm depth appropriate.