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目的探讨右美托咪定在腹腔镜小儿腹股沟疝修补术的临床应用价值。方法择期行腹腔镜腹股沟疝修补术的患儿40例,采用随机数字表法将所有患儿随机分为两组,实验组(右美托咪定组)和对照组(生理盐水组)(n=20),记录两组患儿拔管期间的呛咳发生情况以及拔管期间的血流动力学波动情况,观察两组患儿在PACU期间的躁动发生情况并进行躁动评分,比较两组患儿苏醒时间和拔管时间。结果对照组在手术结束时,其MAP高于基础值(P<0.05)。与对照组相比,实验组患儿在手术结束时、拔管即刻、拔管后1min的MAP均有所降低(P<0.05),而HR在拔管即刻、拔管后1min也低于对照组(P<0.05)。与对照组比较,实验组患儿在拔管期间的呛咳发生率及其呛咳程度明显降低(P<0.05)。在苏醒期躁动发生率和躁动程度的比较上,实验组低于对照组(P<0.05),而两组患儿在苏醒时间和拔管时间的差异无统计学意义。结论右美托咪定可以减轻七氟烷复合麻醉下腹腔镜小儿腹股沟疝修补术气管拔管的呛咳反应并保持血流动力学的稳定,降低患儿全麻苏醒期躁动的发生率,而且不会延长患儿的苏醒时间和拔管时间。
Objective To investigate the clinical value of dexmedetomidine in laparoscopic inguinal hernia repair. Methods Forty children with laparoscopic inguinal hernia repair were randomly divided into two groups randomly. The experimental group (dexmedetomidine group) and the control group (saline group) (n = 20). The occurrence of cough during extubation and hemodynamic fluctuation during extubation were recorded in two groups. The agitation of the two groups was observed during the PACU and agitation score was compared. Children awake time and extubation time. Results At the end of surgery, MAP was higher than baseline (P <0.05). Compared with the control group, MAP in the experimental group was significantly lower at the end of surgery, immediately after extubation and at 1 minute after extubation (P <0.05), while HR was lower at 1 minute after extubation and 1 minute after extubation Group (P <0.05). Compared with the control group, the incidence of cough and the degree of cough in the experimental group during extubation were significantly lower (P <0.05). There was no significant difference between the two groups in recovery time and extubation time in the comparison between the incidence of agitation and restlessness in the experimental group and the control group (P <0.05). Conclusion Dexmedetomidine can reduce the choking reaction of tracheal extubation of laparoscopic pediatric inguinal hernia repair under sevoflurane anesthesia and maintain hemodynamic stability and reduce the incidence of agitation in general anesthesia during anesthesia, Will not extend the recovery time and extubation time in children.