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外科手术是小儿难治性癫的重要治疗手段,年龄已不再是手术的禁忌,这也对麻醉提出更高的要求。小儿无法配合术前检查,麻醉需要围术期全程介入,癫的特点要求在保证麻醉深度的同时,不能影响癫异常放电的观察。当前常用的镇静和全身麻醉药物对呼吸、循环干扰大,且随剂量增大明显抑制全脑放电,故都不是小儿癫疒间手术的理想药物。右美托咪啶作用于α2肾上腺素能受体,抑制突触后去甲肾上腺素释放,起镇静、镇痛作用,其对呼吸、循环干扰小,既不激发也不抑制癫疒间灶异常放电,是较为理想的小儿癫手术麻醉用药。本文就右美托咪啶在小儿癫外科的应用进展作一综述。
Surgery is an important treatment of refractory epilepsy in children, the age is no longer a taboo surgery, which also put forward higher requirements for anesthesia. Children can not cooperate with preoperative examination, anesthesia requires perioperative intervention, the characteristics of epilepsy in ensuring the depth of anesthesia at the same time, can not affect the observation of abnormal epileptic discharge. The commonly used sedation and general anesthetic drugs on respiratory, circulatory disturbance, and with increased dose significantly inhibited the whole brain discharge, it is not ideal for pediatric epilepsy surgery. Dexmedetomidine acts on α2 adrenergic receptors and inhibits the release of postsynaptic norepinephrine, which plays a role of sedation and analgesia. It has little interference with respiration and circulation, and neither excites nor inhibits the abnormality of epilepsy Discharge, is the ideal pediatric epilepsy surgery anesthesia medication. This article reviews the progress of the application of dexmedetomidine in pediatric epilepsy surgery.