右旋美托咪定用于小儿腭裂修复术全麻后苏醒期躁动的影响.docVIP

右旋美托咪定用于小儿腭裂修复术全麻后苏醒期躁动的影响 　　[摘要] 目的 探讨右旋美托咪定对小儿腭裂修复术全麻后苏醒期血流动力学及麻醉苏醒的影响。 方法 将择期行腭裂修复手术的60例患儿随机分为观察组及对照组，各30例，两组患儿麻醉诱导后均行七氟醚吸入麻醉维持，观察组同时应用1 μg/（kg?h）右旋美托咪定持续泵入维持，对照组仅给予同等容积的生理盐水持续泵入维持。 结果 观察组心率、二氧化碳分压、躁动评分、缝合口出血发生率与对照组相比差异有统计学意义（P 0.05）。结论 术中对小儿腭裂修复术患儿应用右旋美托咪定可减少患儿麻醉后苏醒期的躁动，有利于血流动力学平稳，有助于患儿预后。 　　[关键词] 右旋美托咪定；小儿；腭裂；全身麻醉；苏醒期躁动 　　[中图分类号] R782.2 [文献标识码] A [文章编号] 1673-7210（2014）02（c）-0069-03 　　Effect of Dexmedetomidine on awakening period of restlessness after general anesthesia in pediatric palatorrhaphy 　　SHI Wei CHEN Zhifeng▲ 　　Department of Anesthesiology， the Ninth Peoples Hospital Affiliated to School of Medicine of Shanghai Jiaotong University， Shanghai 200011， China 　　[Abstract] Objective To investigate the influence of Dexmedetomidine on the hemodynamics and anesthesia recovery during awakening period after general anesthesia after cleft palate repair therapy. Methods 60 cases of cleft palate children who received repair surgery were divided into two groups randomly and each group contained 30 cases， children of both groups were provided Sevoflurane to maintain the anesthesia after the induction. Children in observation group received 1 μg/（kg?h） Dexmedetomidine and children in observation group received normal saline pumping to maintain. Results The HR， PaCO2， children agitation score and the occurrence rate of seal bleeding compared with the control group， the differences were statistically significant （P 0.05）. Conclusion The application of Dexmedetomidine on cleft palate children during recovery surgery reduces restlessness when they wake up after the anesthesia. It does well in hemodynamic stability and helps the prognosis of children. 　　[Key words] Dexmedetomidine； Children； Cleft palate； General anesthesia； Awakening period of restlessness 　　小儿腭裂修复手术是治疗小儿先天性腭裂畸形有效的方法，麻醉及麻醉后生命体征的平稳一定程度上影响到手术的效果。小儿麻醉常采用七氟醚吸入维持。七氟醚具有对气道刺激小、血气分配系数低、苏醒快、血流动力学稳定的特点，是小儿全麻手术的常用麻醉药物。然而七氟醚全身麻醉可导致患儿苏醒期出现躁动。相关研究指出[1]，七氟醚麻醉诱导麻醉后可导致18%～80%的患儿出现麻醉苏醒其躁动，腭裂修复手术手术部位在口咽部，患儿术后