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目的比较右美托咪定和咪达唑仑抑制患儿气管插管反应的效果。方法拟行斜视矫正术的患儿60例,ASAⅠ或Ⅱ级,性别不限,年龄4~8岁,随机分为2组:右美托咪定组(D组)和咪达唑仑组(M组),麻醉诱导:2组患儿给予丙泊酚,入睡后D组依次静脉泵注右美托咪定0.5 g/kg,芬太尼2 g/kg、罗库溴铵1 mg/kg;M组以相同方法给予咪达唑仑0.1 mg/kg,肌松起效后行气管插管。记录麻醉诱导前(T0)、气管插管时(T1)、插管后1 min(T2)、插管后3 min(T3)、插管后5 min(T4)的心率(HR)、血压(MAP)和肾上腺素(E)、去甲肾上腺素(NE)的浓度。结果 T1~T4时M组MAP、HR显著高于T0时和D组(P<0.05);T3~T4时M组E和NE的浓度显著高于T0时和D组(P<0.05)。结论右美托咪定抑制小儿气管插管时的应激反应的效果优于咪达唑仑。
Objective To compare the effects of dexmedetomidine and midazolam on tracheal intubation in children. Methods Sixty children with ASA Ⅰ or Ⅱ were enrolled in this study. All of them were randomly divided into 2 groups: dexmedetomidine group (D group) and midazolam group M group). Induction of anesthesia: Propofol was given to two groups of children. After falling asleep, group D received intravenous dexmedetomidine 0.5 g / kg, fentanyl 2 g / kg, rocuronium 1 mg / kg ; Group M was given midazolam 0.1 mg / kg in the same way. After the onset of muscle relaxation, tracheal intubation was performed. The heart rate (HR), blood pressure (T), intratracheal intubation (T1), 1 min after intubation (T2), 3 min after intubation (T3), 5 min after intubation (T4) MAP) and epinephrine (E), norepinephrine (NE) concentrations. Results At T1 ~ T4, the MAP and HR of M group were significantly higher than those of T0 and D group (P <0.05). The concentrations of E and NE in M group were significantly higher than those at T0 and D (P <0.05) at T3 ~ T4. Conclusion Dexmedetomidine is superior to midazolam in inhibiting the stress response in children with endotracheal intubation.