右美托嘧啶在预防小儿OSAHS手术苏醒期躁动的应用研究.DOCVIP

术中应用右美托嘧啶在预防幼儿OSAHS手术苏醒期并发症的研究解克强 常鸿 [摘要] 目的 观察右美托嘧啶在预防幼儿OSAHS手术苏醒期躁动的效果。 方法 60例接受OSAHS手术的患儿，随机分为右美托嘧啶组（Y组）和生理盐水组（N组），采用七氟烷吸入诱导,静脉推注瑞芬太尼 2μg?kg-1、顺式阿曲库铵0.15 mg?kg-1, Y组给予右美托嘧啶1μg?kg-1，待BIS为60时行气管插管。术中右美托嘧啶维持速度为0.2μg?kg-1?h-1，手术结束前5min停止输注； N组静注生理盐水。手术结束后所有患儿均拔管，接镇痛泵送入恢复室观察 2 h。记录患儿的手术时间，停药至清醒时间，右美托嘧啶注入前(T0)、拔管时(T1) 、苏醒时(T2) 拔管后10min(T3)、的HR、MAP。 结果 Y组与N组比较，T1～T3时的Y组MAP明显降低，HR明显减慢（P0.05）；Y组3例（10%）、N组15例（50%）有躁动，N组明显高于Y组（P0.05）。 结论 在幼儿OSAHS手术麻醉苏醒期右美托咪啶可以产生镇静、镇痛和抗焦虑作用，明显减少麻醉后疼痛、躁动及血流动力学变化，且不增加不良反应。 [关键词] 右美托嘧啶；幼儿；OSAHS手术；苏醒期躁动 The feasibility of using dexmedetomidine in anesthesia during restlessness of Children OSAHS XIE Ke-qiang,CHANG Hong.Department of Anesthesiology,Second People’s Hospital of Liaocheng City,Liaocheng 252601,China [Abstract] Objective To observe Dexmedetomidine in the prevention of pediatric OSAHS operation restlessness effect.Methods 60 patients underwent OSAHS operation were randomly divided into Dexmedetomidine group (Y group) and Normal saline group ( N group ), with sevofurane inhalation induction, intravenous remifentanil 2 μg? kg-1,cisatracurium 0.15 mg ?kg-1, Y group was given the right search pyrimidine 1μg?kg-11, when the tracheal intubation the BIS is 60. Dexmedetomidine speed is 0.2μg?kg-1? h-1, 5 min operation before the end of the infusion was stopped; group N intravenous saline. After the operation all patients were extubated, analgesia pump into the recovery room observation 2 h. Recording with operation time, stopping time to awake, the right search pyrimidine injected into the anterior (T0), after extubation ( T1 ), children awake(T2),10 min after extubation ( T3 ). Results Compare Y group with N group, T1~ T3 group Y MAP were signifcantly decreased, HR was decreased (P0.05 ); 3 cases in D group (10%), 15 cases in N group ( 50%) a restless, was higher in group N than in group Y ( P0.05).Conclusion OSAHS operation in pediatric anesthesia analepsia period of dexmedetomidine can produce sedative, analgesic and