摘要
目的观察右美托咪啶对预防小儿腹腔镜手术苏醒期躁动的效果。方法选择64例腹腔镜手术小儿,按照随机数字表法分为右美托咪啶组与氯胺酮组各32例。两组小儿常规气管插管,右美托咪啶组泵注稀释为10ml的右美托咪啶1μg/kg,氯胺酮组静脉注射稀释为10ml的氯胺酮0.3mg/kg,术中维持麻醉,观察两组术后不同时间心率、躁动发生率、躁动评分;拔管后不同时间Ramsay镇静程度评分以及苏醒时间等指标。结果右美托咪啶组小儿拔管前、拔管时以及拔管后2分钟的心率均低于氯胺酮组(P<0.05),右美托咪啶组躁动比例、躁动评分均低于氯胺酮组(P<0.05),右美托咪啶组拔管后60、120、180、240分钟Ramsay镇静程度得分均优于氯胺酮组(P<0.05),右美托咪啶组苏醒时间显著短于氯胺酮组(P<0.05)。结论右美托眯啶应用于小儿腹腔镜手术苏醒期躁动效果优于小剂量氯胺酮,安全性好。
Objective To study the effect of dexmedetomidine on the prevention of emergence agitation in pediatric laparoscopic surgery.Method This study takes 64 cases of pediatric laparoscopic surgery as the object of study.Before the surgeries,children are divided with random number table into two groups,group of dexmedetomidine and group of ketamine,with each group having 32 cases.Dexmedetomidine group children are injected with 10 ml dilution conventional trachea cannula with 1μg/kg dexmedetomidine with pump;ketamine group children are intravenously injected with 10 ml dilution conventional trachea cannula with 0.3mg/kg ketamine,during which the children maintain anesthesia.The study observes the heart rate agitation occurrence rate and agitation scale of the two groups at different time post operation;it also observes the indicators of Ramsay sedation scale and awakening time at different time after tube removal.Result the heart rates of dexmedetomidine group children before,during and after the tube removal are lower than ketamine group（P〈0.05）;the agitation proportion and agitation scale of dexmedetomidine group are both lower than ketamine group（P〈0.05）;the Ramsay sedation scale at 60 min,120 min,180 min and240 min after the tube removal of dexmedetomidine group are better than ketamine group（P〈0.05）;the awakening time of dexmedetomidine group is shorter significantly than ketamine group ketamine group（P〈0.05）.Conclusion The application of dexmedetomidine in the prevention of emergence agitation of pediatric laparoscopic surgery has better effect and safer than small-dose ketamine.
作者
王潇
赵斌江
WANG Xiao ZHAO Bin-jiang(Beijing shijitan hospital, capital Medical University, Beijing 100038, China)
出处
《中国临床医生杂志》
2016年第12期34-36,共3页
Chinese Journal For Clinicians
关键词
右美托咪啶
小儿腹腔镜手术
苏醒期
躁动
Dexmedetomidine
Pediatric laparoscopic surgery
Emergence
Agitation
