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目的研究右美托咪定对扁桃体及腺样体切除术患儿七氟醚复合麻醉苏醒期噪动的影响。方法选取拟在全身麻醉气管插管下行扁桃体及腺样体切除手术的患儿80例,将其随机分为观察组和对照组,每组各40例。全部患者都静脉注射芬太尼2μg/kg,异丙酚3 mg/kg完成诱导插入气管插管,手术过程中为患者吸入2%~3.5%七氟醚以维持麻醉效果。观察组插入气管插管后,静脉注射右美托咪定0.2μg/(kg·h),对照组则输注等剂量的氯化钠注射液,比较两组麻醉苏醒期噪动的影响。结果观察组的PAED评分(8.0±1.5)明显低于对照组的(11.9±1.7),且差异有统计学意义(P<0.05)。观察组的躁动发生率、不良反应发生率均明显低于对照组,且差异均有统计学意义(P<0.05)。观察组的麻醉恢复室PACU停留时间明显低于对照组的,且差异有统计学意义(P<0.05)。观察组的手术时间、拔管时间与对照组的比较,差异均未见统计学意义(P<0.05)。结论使用右美托咪定有助于减少患儿苏醒期躁动,帮助患儿平稳度过麻醉苏醒期,并减少术后的不良反应,值得临床进一步推广运用。
Objective To study the effect of dexmedetomidine on the noises of sevoflurane anesthesia in wakefulness of children with tonsillectomy and adenoidectomy. Methods Totally 80 children scheduled for tonsillectomy and adenoidectomy under general anesthesia for tracheal intubation were randomly divided into observation group (n = 40) and control group (n = 40). All patients were intravenously injected fentanyl 2μg / kg, propofol 3mg / kg to complete the induction of endotracheal intubation, during the operation of patients inhaled 2% to 3.5% sevoflurane to maintain anesthesia. After intratracheal intubation, the rats in the observation group were given intravenous dexmedetomidine 0.2μg / (kg · h), while those in the control group were given sodium chloride injection of equal dose. The effects of noise during anesthesia recovery were compared between the two groups. Results The PAED score of the observation group (8.0 ± 1.5) was significantly lower than that of the control group (11.9 ± 1.7), and the difference was statistically significant (P <0.05). The incidence of agitation and adverse reactions in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P <0.05). The PACU stay time in the anesthesia recovery room in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P <0.05). The observation group’s operation time, extubation time and the control group, the difference was not statistically significant (P <0.05). Conclusion The use of dexmedetomidine helps to reduce the restlessness of children, arousal to help children with stable recovery period and reduce postoperative adverse reactions, it is worth further clinical application.