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右旋美托咪啶在小儿全麻苏醒期躁动防治中的应用
Application of Dexmedetomidine on emergence agitation in children After general anesthesia
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DOI:
作者:
郭云秀,马柯,王英伟
Guo Yun Xiu,Ma Ke,Wang Ying Wei
作者单位:
1.上海交通大学医学院附属新华医院(崇明)麻醉科 2.上海交通大学医学院附属新华医院麻醉科 3.上海交通大学医学院附属新华医院麻醉科
1.Department of Anesthesiology, Xin Hua Hospital Affiliated to Shang Hai Jiao Tong University School of Medicine(chong ming) 2. Department of Anesthesiology, Xin Hua Hospital Affiliated to Shang Hai Jiao Tong University School of Medicine 3. Department of Anesthesiology, Xin Hua Hospital Affiliated to Shang Hai Jiao Tong University School of Medicine
关键词:
右旋美托咪啶;苏醒期躁动;丙泊酚;儿童
dexmedetomidine; emergence agitation; propofol; children
摘要:
目的 评价右旋美托咪啶(dexmedetomidine, Dex)在小儿全麻苏醒期躁动防治中的应用。方法 120例择期骨科手术患儿,随机分为四组,每组30例:A组(Dex 0.4μg/kg+0.9%Nacl至10ml)、B组(Dex 0.2μg/kg+0.9%Nacl至10ml)、C组(丙泊酚1mg/kg)与D组(生理盐水10ml)。A组、B组和D组于手术结束前10min分别静脉泵注完成;C组手术结束后静脉注射。小儿苏醒期躁动(emergence agitation EA)评分采用Aono的四分评级法与PAED(儿童麻醉苏醒谵妄评分)法,记录拔管后15min时的EA与PAED评分及躁动发生率。结果 拔管后15min时,A组与B组、C组和D组比较,EA评分与PAED评分显著下降(P<0.05); A组术后躁动发生率也显著低于B组、C组和D组。结论 手术结束前10分钟静脉输注Dex0.4μg/Kg/10min,能降低小儿苏醒期的躁动率。
Objective To evaluate the effect of Dexmedetomidine (Dex) on emergence agitation in children after general anesthesia. Methods 120 pediatric patients undergoing elective orthopedic operation were randomly divided to four groups (each n = 30): group A (Dex 0.4μg/kg+0.9%Nacl to 10ml), group B (Dex0.2μg/kg+0.9%Nacl to 10ml), group C (propofol 1mg/kg) and group D(saline 10ml). 10 min before the end of operation, group A, group B and group D were continuously administrated by injection pump within 10 min respectively. Group C was administrated after the end of operation. Aono four point rating method and Pediatric anesthesia emergence delirium scale (PAED) methods were used for scoring the children emergence agitation (EA), recorded EA, PAED scores and the incidence of agitation after extubation. Results EA and PAED scores are significantly decreased in group A compared with which in group B, groupC and group D (P<0.05). There is no significant difference between group B, group C and group D (P>0.05).The incidence of agitation of group A is decreased respectively compared with group B、group C and group D. Conclusion 10 min before the end of operation, administration with Dex 0.4μg/kg/10min can decreased the incidence of agitation during the recovery period of children.
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