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目的评价右美托咪定在小儿纤维支气管镜检查术中的麻醉效果。方法 60例接受纤维支气管镜检查的患儿,ASAⅠ或Ⅱ级,1~3岁,随机分为右美托咪定组(D组)和对照组(C组),每组30例。术前30 min静脉注射阿托品0.01 mg/kg,于麻醉诱导前约10 min由家长陪同进入麻醉准备室,D组5 min内泵注右美托咪定0.5μg/kg,C组给予同等容量的0.9%氯化钠溶液。2组采用丙泊酚2 mg/kg、芬太尼1μg/kg诱导后,开始镜检操作,术中均保留自主呼吸。记录2组镜检时间、苏醒时间、清醒时躁动发生率;对2组麻醉效果进行评级;观察2组各时间点MAP、HR变化。结果 D组清醒时躁动发生率低于C组(P<0.05)。D组镇痛效果优于C组(P<0.05)。与T0时比较,T1时2组平均动脉压(MAP)、心率(HR)均明显降低(P<0.05),T2~T4时C组MAP明显升高、D组HR明显降低(P<0.05);与C组比较,T1时D组HR明显降低,T2~T4时D组MAP、HR均明显降低(P<0.05)。结论右美托咪定复合丙泊酚、芬太尼用于小儿纤维支气管镜检查术,麻醉效果满意。
Objective To evaluate the anesthetic effect of dexmedetomidine in pediatric bronchofibroscopy. Methods Sixty children undergoing fibrobronchoscopy, ASA Ⅰ or Ⅱ, aged 1 to 3 years, were randomly assigned to receive dexmedetomidine (group D) and control (group C), 30 patients in each group. Intravenous injection of atropine 0.01 mg / kg 30 min before surgery was accompanied by the parents about 10 min prior to anesthesia induction into the anesthesia preparation room. Group D was given dexmedetomidine 0.5 μg / kg within 5 min, while group C was given the same volume 0.9% sodium chloride solution. 2 groups were treated with propofol 2 mg / kg and fentanyl 1 μg / kg, and the microscopic examination was started. Both groups maintained spontaneous breathing. Record the time of microscopic examination, the recovery time and the incidence of agitation when awake. The anesthetic effects of two groups were rated. The changes of MAP and HR were observed at two time points. Results The incidence of agitation in group D was lower than that in group C (P <0.05). Analgesia in group D was better than group C (P <0.05). Compared with T0, mean arterial blood pressure (MAP) and heart rate (HR) in group 2 were significantly decreased at T1 (P <0.05), MAP at C group was significantly increased at T2 ~ T4, HR was significantly lower in group D (P0.05) Compared with group C, the HR of group D decreased significantly at T1 and the MAP and HR of group D decreased significantly at T2 ~ T4 (P <0.05). Conclusion Dexmedetomidine combined with propofol and fentanyl for pediatric bronchoscopy has satisfactory anesthetic effect.