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右美托咪定对全身麻醉扁桃体切除术患儿苏醒期躁动的影响 预览

Effect of dexmedetomidine on agitation during general anesthesia recovery period in children underwent tonsillectomy
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摘要 目的探讨右美托咪定对全身麻醉扁桃体切除术患儿苏醒期躁动的影响。方法选择2017年1月至2018年3月于河南省人民医院择期行全身麻醉扁桃体切除术的106例患儿为研究对象,根据术中是否应用右美托咪定分为右美托咪定组和对照组,每组53例。所有患儿实施气管插管全身麻醉,右美托咪定组患儿术中持续静脉泵注右美托咪定镇静,对照组患儿未应用右美托咪定。记录2组患儿进入手术室时(T0)、气管插管拔除时(T1)的心率(HR)和脉搏氧饱和度(Sp O)2),比较2组患儿气管插管拔除时间、自主呼吸恢复时间、苏醒期躁动及不良反应发生情况;采用Ramsay镇静评分评估患儿苏醒期躁动程度。结果 2组患儿T0时HR及Sp O)2比较差异无统计学意义(P>0.05)。2组患儿T1时Sp O)2低于T0时(P<0.05),对照组患儿T1时HR高于T0时(P<0.05),右美托咪定组患儿T0、T1时HR比较差异无统计学意义(P>0.05)。T1时右美托咪定组患儿HR低于对照组(P<0.05),但T1时2组患儿Sp O)2比较差异无统计学意义(P>0.05)。2组患儿气管插管拔除时间及自主呼吸恢复时间比较差异无统计学意义(P>0.05),右美托咪定组患儿苏醒期Ramsay评分高于对照组(P<0.05)。对照组和右美托咪定组患儿苏醒期不良反应发生率分别为22.64%(12/53)、5.66%(3/53),右美托咪定组患儿苏醒期不良反应发生率低于对照组(χ~2=6.290,P<0.05)。结论右美托咪定用于小儿全身麻醉下扁桃体切除术安全可行,可有效降低全身麻醉苏醒期躁动和不良反应发生率。 Objective To investigate the effect of dexmedetomidine on agitation during general anesthesia recovery period in children underwent tonsillectomy.Methods A total of 106 children who underwent tonsillectomy under general anesthesia from January 2017 to March 2018 in Henan Provincial People’s Hospital were selected as the study subjects,and the children were divided into dexmedetomidine group and control group according to whether dexmedetomidine was used during operation,53 cases in each group.All the children were given general anesthesia through tracheal intubation.The children in the dexmedetomidine group were given dexmedetomidine by continuous intravenous drip during the operation,while no dexmedetomidine was used in the children of the control group.The heart rate(HR)and pulse oxygen saturation(Sp O)2)were recorded at the time points of entering the operating room(T0)and tracheal intubation extubation(T1).The tracheal intubation extubation time,spontaneous breathing recovery time,agitation during anesthesia recovery period and adverse reactions were compared between the two groups.The agitation during anesthesia recovery period was evaluated by Ramsay score.Results There was no significant difference in HR and Sp O)2 between the two groups at T0(P>0.05).The Sp O)2 at T1 was lower than that at T0 in the two groups(P<0.05),the HR at T1 was higher than that at T0 in the control group(P<0.05),but there was no significant difference in HR between T0 and T1 in the dexmedetomidine group(P>0.05).The HR in the dexmedetomidine group was lower than that in the control group at T1(P<0.05),but there was no significant difference in Sp O)2 between the two groups at T1(P>0.05).There was no significant difference in tracheal intubation extubation time and spontaneous breathing recovery time between the two groups(P>0.05).The Ramsay score of the patients during anesthesia recovery period in the dexmedetomidine group was higher than that in the control group(P<0.05).The incidence of adverse reactions during anesthesia recov
作者 周军 张原源 丛旭晖 宋丽霞 张加强 ZHOU Jun;ZHANG Yuan-yuan;CONG Xu-hui;SONG Li-xia;ZHANG Jia-qiang(Department of Anesthesiology,Henan Provincial People's Hospital,Zhengzhou 450003,Henan Province,China)
出处 《新乡医学院学报》 CAS 2019年第4期353-356,共4页 Journal of Xinxiang Medical College
基金 河南省医学科技攻关计划联合共建项目(编号:2018020397) 河南省医学科技攻关计划项目(编号:201602228).
关键词 右美托咪定 扁桃体切除术 全身麻醉 气管插管 麻醉苏醒期 躁动 不良反应 dexmedetomidine tonsillectomy general anesthesia tracheal intubation anesthesia recovery period agitation adverse reaction
作者简介 周军(1971-),女,河南郑州人,博士,副主任医师,研究方向:小儿麻醉及药物代谢;通信作者:张加强(1976-),男,河南开封人,博士,主任医师,研究方向:心胸外科麻醉、吸入麻醉药物对患者认知功能的影响,E-mail:hnmzxh@163.com.
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