右美托咪定用于小儿麻醉对血流动力学及对苏醒期躁动和术后疼痛影响.docVIP

右美托咪定用于小儿麻醉对血流动力学及对苏醒期躁动和术后疼痛影响 　　[摘要] 目的 ?^察右美托咪定用于小儿麻醉对血流动力学及苏醒期躁动和术后疼痛的影响。 方法 选择2016年3月～2017年3月武汉大学人民医院收治的接受扁桃体、腺样体择期切除术的患儿60例，随机分为右美托咪定组和对照组，每组各30例。右美托咪定组给予右美托咪复合七氟醚行麻醉维持，对照组仅给予七氟烷维持麻醉，比较两组患儿的手术时间、麻醉时间、拔管时间及苏醒时间；比较两组患儿麻醉前（T0）、气管插管时（T1）、手术开始即刻（T2）、手术结束即刻（T3）、心率（HR）、平均动脉压（MAP）；比较两组患儿躁动量化评分（PAED）、躁动发生率及术后疼痛程度（FPS评分）。 结果 两组患儿一般情况及手术、麻醉、拔管及苏醒时间差异均无统计学意义（P 0.05）；两组间T1、T2、T3时点HR、MAP值均高于T0，T0时点HR、MAP两组差异均无统计学意义（P 0.05）；与对照组比较，右美托咪定组T1时点HR和MAP值，T3时点HR值均低于对照，差异有统计学意义（P 0.05）；右美托咪定组患儿躁动发生率低于对照组，PAED评分和FPS疼痛评分均低于对照组，差异有统计学意义（P 0.05）。 结论 右美托咪定用于小儿择期手术可发挥稳定血流动力学，降低躁动发生和减轻疼痛的作用，可增加麻醉的安全性与舒适性。 　　[关键词] 右美托咪定；麻醉；小儿；血流动力学；苏醒期躁动；术后疼痛 　　[中图分类号] R971.2 [文献标识码] A [文章编号] 1673-7210（2018）03（a）-0094-05 　　[Abstract] Objective To observe the effects of Dexmedetomidine on hemodynamics， emergence agitation and postoperative pain in children under anesthesia. Methods A total of 60 children with tonsillectomy and adenoidectomy in Renmin Hospital of Wuhan Universiy from March 2016 to March 2017 were selected and randomly divided into Dexmedetomidine group and control group， with 30 cases in each group. Children in the Dexmedetomidine group were given the Dexmedetomidine combined with Sevoflurane for maintenance of anesthesia， and children in the control group were given the Sevoflurane only for anesthesia maintenance. The operation time， anesthesia time， extubation time and recovery time， Heart rate （HR） and mean arterial pressure （MAP） were compared between the two groups in the times that before anesthesia （T0）， tracheal intubation （T1）， beginning of surgery （T2）， end of surgery （T3）. The incidence of emergence agitation， the PAED score and FPS score were investigated in the two groups. Results There were no statistically significant difference in operation time， anesthesia time， extubation time and recovery time between the two groups （P 0.05）. HR and MAP were higher at the time T1， T2 and T3 than those at T0 in both groups and there was no statistically significant difference in HR