论文部分内容阅读
目的评价右美托咪定对儿童全身麻醉气管插管和拔管反应的影响。方法选取择期全身麻醉手术患儿40例,年龄7~12岁,美国麻醉医师协会分级Ⅰ、Ⅱ级。随机分为右美托咪定组(D组)及生理盐水组(M组),每组20例。D组诱导前给予右美托咪定0.5μg/kg,用生理盐水稀释到10ml,微量输液泵静脉注射,10min注完;M组诱导前给予等量生理盐水10ml;两组均用芬太尼4μg/kg,丙泊酚2mg/kg,顺式阿曲库铵0.2mg/kg,完成气管插管;术中持续吸入七氟醚麻醉维持。观察两组全身麻醉插管、拔管期间血流动力学变化,观察拔管时间、睁眼时间、苏醒时Ramsay评分及苏醒期躁动情况。结果 D组麻醉插管、拔管前后血液动力学变化相对平稳,M组在插管后1min、插管后5min、拔管后即刻、拔管后5min血压升高,心率加快,与D组比较差异有统计学意义(P<0.05)。D组苏醒时Ramsay评分高于M组(P<0.05),D组睁眼时间迟于M组(P<0.05),D组苏醒期躁动2例,M组躁动17例,差异有统计学意义(P<0.05)。结论诱导前右美托咪定静脉泵注对气管插管拔管时血流动力学影响小,Ramsay评分升高,可降低躁动的发生。
Objective To evaluate the effect of dexmedetomidine on tracheal intubation and extubation in general anesthesia in children. Methods Forty children with elective general anesthesia were selected, aged from 7 to 12 years old. The American Academy of Anesthesiologists graded Ⅰ and Ⅱ. Randomly divided into dexmedetomidine group (D group) and saline group (M group), 20 cases in each group. D group before dexmedetomidine given 0.5μg / kg, diluted with saline to 10ml, intravenous infusion of trace infusion pump, 10min note End; M group before induction of equal amount of normal saline 10ml; both groups were treated with fentanyl 4μg / kg, propofol 2mg / kg, cisatracurium 0.2mg / kg, complete tracheal intubation; continuous inhalation of sevoflurane anesthesia to maintain. The general anesthesia intubation, hemodynamic changes during extubation, extubation time, eyes open time, Ramsay score at awakening and restless recovery were observed. Results The changes of hemodynamics in group D were relatively stable before and after extubation. In group M, the blood pressure increased at 1 min after intubation, 5 min after intubation, immediately after extubation, 5 min after extubation, and the heart rate accelerated compared with group D The difference was statistically significant (P <0.05). The Ramsay score of group D was higher than that of group M (P <0.05), the time of eyes opening of group D was later than that of group M (P <0.05), the restless group (group D) (P <0.05). Conclusion Before the induction of dexmedetomidine intravenous infusion of endotracheal intubation hemodynamics when extubated small, Ramsay score increased, can reduce the occurrence of agitation.