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中华临床医师杂志(电子版) ›› 2017, Vol. 11 ›› Issue (13) : 1970 -1973. doi: 10.3877/cma.j.issn.1674-0785.2017.13.002

所属专题: 文献

临床论著

右美托咪定联合氟比洛芬酯对小儿腹腔镜手术全麻苏醒期躁动的影响
徐晶晶1, 高宏1, 王志萍1,()   
  1. 1. 214023 南京医科大学附属无锡市人民医院麻醉科
  • 收稿日期:2015-03-16 出版日期:2017-07-01
  • 通信作者: 王志萍

Dexmedetomidine combined with fexmedetomidine alleviates emergence agitation during recovery from pediatric laparoscopic surgery

Jingjing Xu1, Hong Gao1, Zhiping Wang1,()   

  1. 1. Department of Anesthesia, People′s Hospital of Wuxi Affiliated to Nanjing Medical University, Wuxi 214000, China
  • Received:2015-03-16 Published:2017-07-01
  • Corresponding author: Zhiping Wang
  • About author:
    Corresponding author: Wang Zhiping,
引用本文:

徐晶晶, 高宏, 王志萍. 右美托咪定联合氟比洛芬酯对小儿腹腔镜手术全麻苏醒期躁动的影响[J/OL]. 中华临床医师杂志(电子版), 2017, 11(13): 1970-1973.

Jingjing Xu, Hong Gao, Zhiping Wang. Dexmedetomidine combined with fexmedetomidine alleviates emergence agitation during recovery from pediatric laparoscopic surgery[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(13): 1970-1973.

目的

观察右美托咪定联合氟比洛芬酯应用于小儿腹腔镜手术对全麻苏醒期的安全性和可行性。

方法

将2015年10月至2016年12月南京医科大学附属无锡市人民医院60例ASAⅠ级2~10岁在全麻下行小儿腹腔镜鞘状突高位结扎术和疝修补术的患儿,随机分为3组(n=20):氟比洛芬酯组(F组)、氟比洛芬酯联合右美托咪定组(FD组)、对照组(C组),麻醉诱导前分别静注1 mg/kg氟比洛芬酯、1 mg/kg氟比洛芬酯及0.5 μg/kg右美托咪定、与F组等容量生理盐水。记录3组患儿拔管前(T0)、拔管即刻(T1)、拔管后5 min(T2)各时点平均动脉压(MAP)、心率(HR)的变化,记录苏醒时间、拔管时间、拔管后呼吸道事件及苏醒期躁动发生情况。

结果

与C组比较,FD组在T0、T1、T2时刻MAP和HR显著降低(P<0.01或P<0.05);与C组比较,F组在T2时MAP和HR显著降低(P<0.01);与F组比较,FD组心率在MAP和HR下降(P<0.05)。与C组比较,FD组呼吸道事件和躁动发生率降低,差异有统计学意义(P<0.05)。

结论

麻醉诱导前联合应用氟比洛芬酯和右美托咪定可以有效减少小儿腹腔镜手术全麻苏醒期躁动,提高麻醉安全性,不延长患儿苏醒时间和拔管时间。

Objective

To observe the safety and feasibility of combined administration of dexmedetomidine with fexmedetomidine in alleviating emergence agitation during recovery from pediatric laparoscopic surgery.

Methods

Sixty 2-10-year-old children who underwent high ligation of the processus vaginalis or herniorrhaphy at the People′s Hospital of Wuxi Affiliated to Nanjing Medical University from October 2015 to December 2016 were randomly divided into three groups (n=20 each). Before anesthesia induction, the patients were intravenously injected with fexmedetomidine 1 mg/kg (group F), dexmedetomidine 0.5 μg/kg plus fexmedetomidine 1 mg/kg (group FD), or normal saline (group C). Mean arterial pressure (MAP) and heart rate (HR) were recorded before extubation (T0), at extubation (T1), and 5 min after extubation (T2). During the time course of recovery and extubation, respiratory events and psychomotor agitation were recorded.

Results

Compared with group C, MAP and HR at T0, T1, and T2 in group FD, and MAP and HR at T2 in group F were significantly decreased (P<0.05). Compared with group F, MAP and HR at T2 in group FD were significantly decreased (P<0.05). The incidence rates of respiratory events and psychomotor agitation in group FD were significantly lower than those in other groups (P<0.05).

Conclusion

Dexmedetomidine combined with dexmedetomidine can effectively prevent psychomotor agitation during recovery from pediatric laparoscopic surgery and improve the security, without prolonging the recovery and extubation time.

表1 3组患者一般资料的比较(±s
表2 3组患者复苏期间不同时点MAP、HR的变化比较(±s
表3 3组患者麻醉恢复时间、拔管时间、呼吸道事件和术后躁动情况的比较(min,±s
表4 3组患者呼吸道事件和术后躁动发生率的比较
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