论文部分内容阅读
目的研究右美托咪啶预防患儿腹腔镜手术苏醒期躁动的临床效果。方法选取2013年5月至2014年5月接受腹腔镜手术治疗的患儿64例,术前将所有患儿按照随机数字表法分为右美托咪啶组与氯胺酮组各32例,行气管插管后右美托咪啶组泵注稀释为10 ml的1μg/kg右美托咪啶,氯胺酮组静脉注射稀释为10 ml的0.3 mg/kg氯胺酮,术中常规维持麻醉状态。观察两组患者术后不同时间心率、躁动发生率及躁动评分;拔管后不同时间Ramsay镇静程度评分以及苏醒时间等指标。结果右美托咪啶组患儿拔管前、拔管时以及拔管后2 min的心率均优于氯胺酮组(P均<0.01);右美托咪啶组躁动发生率、躁动评分均优于氯胺酮组(P均<0.01);右美托咪啶组拔管后120、180、240 min Ramsay镇静程度得分均优于氯胺酮组(P均<0.01);右美托咪啶组苏醒时间显著低于氯胺酮组(P<0.01)。结论右美托咪啶应用于患儿腹腔镜手术苏醒期躁动其效果显著优于小剂量的氯胺酮,且具有较强的安全性。
Objective To study the clinical efficacy of dexmedetomidine in preventing wakefulness during laparoscopic surgery in children. Methods Sixty-four children undergoing laparoscopic surgery from May 2013 to May 2014 were selected. All children were divided into two groups according to random number table: 32 cases in each group and 32 cases in tracheal group After intubation, the dexmedetomidine group was injected with 10 μg of 1 μg / kg dexmedetomidine and the ketamine group was injected with 10 ml of 0.3 mg / kg ketamine intravenously. The anesthesia was routinely maintained during the operation. The heart rate, the incidence of agitation and agitation at different time points after operation were observed. The scores of Ramsay sedation and recovery time at different time after extubation were observed. Results The dexmedetomidine group had better heart rate before extubation, extubation and 2 min after extubation than those in ketamine group (all P <0.01). The incidence of agitation and agitation in dexmedetomidine group were superior (P <0.01). The scores of sedation of Ramsay in dexmedetomidine group at 120, 180 and 240 min after extubation were better than that of ketamine group (all P <0.01), and the recovery time of dexmedetomidine group was significantly Lower than ketamine group (P <0.01). Conclusion The application of dexmedetomidine in the recovery stage of laparoscopic surgery in children with agitation is significantly better than low-dose ketamine, and has strong safety.