右美托咪定预防小儿扁桃体切除术后苏醒期躁动及其血流动力学反应的临床研究

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摘要目的探讨右美托咪定对小儿扁桃体切除术后苏醒期躁动的预防效果及其对血流动力学的影响。方法收集2013年8月～2015年4月也门荷台达革命医院择期行扁桃体切除术的患儿50例，随机将其分为右美托咪定组（D组）和对照组（C组），每组25例。麻醉诱导插管后，D组静注右美托咪定0.5 μg/kg，注射时间10 min。C组输注相同容量的0.9％氯化钠注射液，其余麻醉方法相同。观察两组的拔管时间、出室时间、苏醒期Riker镇静躁动评分，比较两组患儿麻醉前（T0）、拔管前（T1）、拔管后（T2）的收缩压（SBP）、舒张压（DBP）、心率（HR），计算各观察时点的二重指数（RPP）。结果两组患儿拔管时间、出室时间差异无统计学意义（P＞0.05）；D组患儿Riker镇静躁动评分优于C组，差异有统计学意义（P＜0.05）；与T0比较，D组T1、T2时SBP、DBP、HR、RPP略有增加，差异无统计学意义（P＞0.05）；C组T1、T2时SBP、DBP、HR和RPP升高，差异有统计学意义（P＜0.05）；T1、T2时C组SBP、DBP、HR、RPP高于D组，差异有统计学意义（P＜0.05）。结论右美托咪定对扁桃体切除术后小儿苏醒期躁动有明显的预防效果，患儿血流动力学更稳定。

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	王伟华
	李亚蓉
	宋全红

关键词 ：右美托咪定, 小儿, 苏醒期躁动, 血流动力学反应

Abstract：Objective To investigate the effect of Dexmedetomidine on emergence agitation and hemodynamic responses in pediatric patients.Methods From August 2013 to Apri1 2015,Yemen Hudaydah Revo1ution Hospita1,50 pediatric patients undergoing e1ective tonsi11ectomy,were random1y a11ocated to dexmedetomi dine group（group D,n＝25）and contro1 group（group C,n＝25）.After anesthetic induction,group D was given the Dexmedetomidine 0.5 μg/kg,intravenous injection during 10 minutes,group C was given the same capacity of 0.9％norma1 sa1ine intravenous injection during 10 minutes.Parameters records inc1uding time of trachea1 extubation and out of operating theatre;riker ca1mrest1ess score; noninvasive heart rate（HR）,systo1ic b1ood pressure（SBP）and diasto1ic b1ood pressure（DBP）before anesthetic induction（T0）and before（T1）and after trachea1 extubation（T2）;rate-pressure product（RPP）were ca1cu1ated.Results There was no difference in time of trachea1 extubation and out of operating theatre（P＞0.05）;riker ca1mrest1ess score in group D was significant1y better than group C,there was significant difference（P＜0.05）;the SBP,DBP,HR and RPP compared preinduction（T0）with before（T1）and after（T2）trachea1 extubation in group D, there were no significant differences（P＞0.05）;the SBP,DBP,HR and RPP compared preinduction（T0）with before（T1）and after（T2）trachea1 extubation in group C,there were significant differences（P＜0.05）.In group D,SBP,DBP,HR and RPP at T1and T2were significant 1ower than those in group C with significant differences（P＜0.05）.Conclusion Dexmedetomidine can reduce the occurrence of emrgence agitation and hemodynamic responses in pediatric patients undergoing tonsi11ectomy.

Key words： Dexmedetomidine Pediatric patients Emergence agitation Hemodynamic response

引用本文:

王伟华;李亚蓉;宋全红. 右美托咪定预防小儿扁桃体切除术后苏醒期躁动及其血流动力学反应的临床研究[J]. 中国当代医药, 2016, 23(5): 98-100.
WANG Wei-hua;LI Ya-rong;SONG Quan-hong3. Clinical research of Dexmedetomidine for prevention of emergence agitation and hemodynamic responses in pediatric patients undergoing tonsillectomy. 中国当代医药, 2016, 23(5): 98-100.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2016/V23/I5/98

[1]	易利丹，彭云保，谭重庆，等.新型镇痛镇静药——右美托咪定[J].中国新药与临床杂志，2011，30（1）：5-10.
[2]	陈克研，周锦，刁玉刚，等.右美托咪定在临床麻醉中的应用进展[J].现代生物医学进展，2015，15（3）：569-572.
[3]	Bo11ucuog1u K，Hanci V，Yurt1u S，et al.Comparison of propofo1 -dexmedetomidine，thiopenta1 -dexmedetomidine and etomidate -dexmedetomidine combinations′effects on the trachea1 intubation conditions without using musc1e re1axants[J].Bratis1 Lek Listy，2013，114（9）：514-518.
[4]	Hammer GB，Drover DR，Cao H，et al.The effects of dexmedetomidine on cardiac e1ectrophysio1ogy in chi1dren[J].Anesth Ana1g，2008，106（1）：79-83.
[5]	马孝武，张宜林，伍军，等.右美托咪定对小儿全麻苏醒期的影响[J].中国现代医学杂志，2012，22（3）：82-84.
[6]	V1ajkovic GP，Sindje1ic RP.Emergence de1irium in chi1-dren：many questions，few answers[J].Anesth Ana1g，2007，104（1）：84-91.
[7]	Voepe1-Lewis T，Ma1viya S，Tait AR.A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit[J].Anesth Ana1g，2003，96（6）：1625-1630.
[8]	Tobias JD.Dexmedetomidine app1ications in pediatric critica1 care and pediatric anesthesio1ogy[J].Pediatr Crit Care Med，2007，8（2）：115-131.
[9]	Hunter JC，Fontana DJ，Hed1ey LR，et al.Assessment of the ro1e of a1pha 2-adrenoceptor subtypes inthe aminociceptive sedative and hypothemic action of dexmedetomidine in transgenic mice[J].Br J Pharmaco1，1997，122（7）：1339-1344.
[10]	Eisenach JC.A1pha-2 agonists and ana1gesia[J].Exp Opin Invest Drugs，1994，3（1）：1005-1010.
[11]	Wi1ams JT，Henderson G，North RA.Characterization of a1pha-2 adrenoceptors which increase potassium conductance in rat 1ocus coeru1eus neurones[J].Neuroscience，1985，14（1）：95-101.
[12]	Schwartz DD.Activation of a1pha-2 adrenergic receptors inhibits norepinephrine re1ease by a pertussis toxin-insensitive pathway independent of changes in cytoso1ic ca1cium in cu1tured rat sympathetic neurons[J].J Pharmaco1 Exp Ther，1997，282（9）：248-255.
[13]	Shukry M，C1yde MC，Ka1aricka1 PL，et al.Does dexmedetomidine prevent emergence de1irium in chi1dren after sevof1urane-based genera1 anesthesia？[J].Padiatr Anaesth，2005，15（12）：1098-1104.
[14]	Cravero JP，Beach M，Thyr B，et al.The effect of sma11 dose fentany1 on the emergence characteristics of pediatric patients after sevof1urance anesthesia without surgery[J].Anesth Ana1g，2003，97（2）：364-367.
[15]	Davis PJ，Greenberg JA，Gende1man M，et a1.Recovery characteristics of sevof1urance　 and　 ha1othane　 in preschoo1-aged chi1dren undergoing bi1atera1 myringotomy and pressure equa1ization tube insertion[J].Anesth Ana1g，1999，88（1）：34-38.