终稿：右美托咪定对脑瘫患儿七氟醚麻醉苏醒期躁动的影响重点解读.docVIP

DOI:10.3760/cma.j.issn.0254-1416.2013.06.007(中华麻醉学杂志) 麻醉并发症 右美托咪定对脑瘫患儿苏醒期躁动的影响 赵泽宇(　刘建波　张蓉　黄建盛　王馨雪 【摘要】 目的右美托咪定对脑瘫患儿。方法择期行肌力肌张力调整术的脑瘫患儿50例，ASA级，年龄2～12岁，性别不限。对照组(C组)右美托咪定(D组)D组15 min静脉右美托咪定0.5 μg/kg，C组等容量生理盐水，手术，术中吸入七氟醚维持麻醉，维持BIS值45-60。右美托咪定前（T1）、切皮T2）记录麻醉期间七氟醚用量T1、T2、术毕(T3)采用小儿苏醒期烦躁量表（PAED）于T1、T2、T3和拨管时(T4)采集外周静脉血，测定血糖血清皮质醇浓度结果与C组比较，D组苏醒时间和拨管时间明显缩短七氟醚T2和T3时呼气末七氟醚浓度、PAED评分T4时血糖和血清皮质醇浓度降低（P＜0.05或0.01）SBP和DBP比较差异无统计学意义，（P＞0.05），两组患儿在观察期间均无房室传导阻滞及异常血压降低的发生。结论　右美托咪定脑瘫患儿七氟醚麻醉后苏醒期躁动。【关键词】　右美托咪定；；精神运动性激动；脑性瘫痪；Effect of dexmedetomidine on emergence agitation of sevoflurane inhalation anesthesia in children with cerebral palsy surgery ZHAO Ze-yu, LIU Jian-bo, ZHANG Rong, HUANG Jian-sheng, WANG Xin-xue. Department of Anesthesiology, The 81 Rehabilitation Center of Sichuan, Chengdu 611135, China Corresponding author: ZHAO Ze-yu, Email: gyzhaozy@163.com 【Abstract】 Objective To investigate the effect of dexmedetomidine on emergence agitation of sevoflurane inhalation anesthesia in children with cerebral palsy surgery. Methods Fifty ASA Ⅰor Ⅱchildren of both sexes, aged 2-12 yr with weighing 10-52 kg undergoing cerebral palsy muscle strength muscle tension adjustment method were randomly allocated into two groups (n=25 each): dexmedetomidine group(group D) and control group（group C）. Anesthesia was induced there was an intravenous infusion of dexmedetomidine 0.5ug/kg in over 15 minutes in group D and infusion of normal saline in group C. The operation was begun after the end of injection. Anesthesia was maintained with sevoflurane from 2% to 4% and the concentration was adjusted to achieve a target BIS of 45-60. The heart rate, SBP and DBP were recorded at the time points before intravenous infusion of dexmedetomidine(T1) and beginning of operation(T2) , the extubation time, recovery time and the consumption of sevoflurane were also recorded. The end-tidal sevoflurane concentration(ETsev%) was assessed at the time points T1, T2,and the end of operation (T3). Record The adverse