右美托咪定联合表面麻醉在小儿支气管异物取出术中的应用

Abstract
Figure/Table
References (16)
Related Citation (15)

Download: PDF (0 KB) HTML (47 KB)
Export: BibTeX | EndNote (RIS)

Abstract

Objective To evaluate the effect of Dexmedetomidine combined with topical anesthesia used for airway foreign body removal in children. Methods Ninety pediatric patients undergoing rigid bronchoscopy examination2，MAP were recorded at four time point：before inhalation anesthesia　（T0），at 15min after topical anesthesia　（T1），at 1 and 5min after inserting bronchoscope　（T2，T3）.Adverse reaction after anesthesia，in the process of bronchoscopy and after operation，and anesthesia handle and so on.Results Compared with group R and T，HR，RR and MAP wasmore stable in group D，SpO2is not as stable as group T，but it could be acceptable level after inhaling of oxygen.Compared with group R and T，the complications such as nausea，cough，holding breath，respiratory depression，laryngospasm，bronchospasm and restlessness throughout the procedure was less in group D.The occurrence rate of bradycardia is higher in group D，but it can be prevention and treatment by Atropine injection.Conclusion Dexmedetomidine combined with topical anesthesia used for airway foreign body removal in children is a safe and feasiblemethod received by our hospital from January 2015 to August 2016 were selected and randomly divided into three groups：Dexmedetomidine+Propofol+topical anesthesia group（group D），simple topical anesthesia group（group T）and Remifentanil+Propofol+ topical anesthesia group　（group R），and there were 30 cases in each group.All patients inhaled Sevoflurane for anesthesia induction and then given topical anesthesia　（Lidocaine of 2mg/kg）.In group D，Propofol of 0.15mg/（kg·min）for continuous intravenous infusion and Dexmedetomidine of 4μg/（kg·h）for intravenous infusion for loading dose，and then 4μg　（kg·min）were continuously infusion until the end of surgery，the patients inhaled Sevoflurane until before surgery.In group R，Propofol of 0.10mg/（kg·min）for intravenous infusion and Remifentanil of 0.1μg/（kg·min）were administered until the end of surgery.In group T，the patients given Sevoflurane for continuousmask inhalation for 15minutes.In the whole process of anesthesia，all patients kept their own breathin.HR，RR，SpO

Key words： Dexmedetomidine Pediatric anesthesia Rigid bronchoscopy Airway foreign body Remifentanil Propofol

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	OUYANG Ai-ping
	LIU Shi-wen
	LIYou-chun
	LILi
	HUANG Yi-sheng
	LIYi-ping
	GUO Li-li

Cite this article:

OUYANG Ai-ping,LIU Shi-wen,LIYou-chun, et al. App lication of Dexmedetom idine combined with topical anesthesia in removal of bronchial foreign bodies in children[J]. 中国当代医药, 2016, 23(29): 97-100.

URL:

http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2016/V23/I29/97

［1］	邓小明，姚尚龙，于布为，等.现代麻醉学（第四版）［M］.北京：人民卫生出版社，2014：1471-1473.
［5］	郑羡河.高频喷射呼吸机在气管异物取出术中的应用［J］.实用医学杂志，2005，21（4）：385-386.
［2］	Christina W，Fidkowski MD，Zheng H，et al.The anesthetic considerationsof trachebronchial foreign bodies in children：a literature review of 12979 cases［J］.Anesth Analg，2010，111（4）：1016-1025.
［3］	Cai Y，Li W，Chen K.Efficacy and safety of spontaneous ventilation technique using dexmedetomidine for rigid bronchoscopic airway foreign body removal in children［J］Paediartr Anaesth，2013，23（11）：1048-1053.
［4］	Chen K，Shen X.Dexmedetomidine and propofol total intravenous anesthesia for airway foreign body removal［J］.Ir J Med Sci，2014，183（3）：481-484.
［6］	李民，张利萍，吴新民.右美托咪啶在临床麻醉中应用的研究进展［J］.中国临床药理学杂志，2007，23（11）：466-470.
［7］	郝静，马正良.α2-受体激动剂在围术期中的应用进展［J］.国际麻醉学与复苏杂志，2010，31（3）：267.
［8］	Dutta S，Karol MD，Cohen T，et al.Effect of dexmedetomidine on propotol requirements in healthy subjects［J］.JPharm Sci，2001，90（20）：172-181.
［9］	樊友凌，彭惠华，黄芳，等.右美托咪定复合靶控输注异丙酚-瑞芬太尼用于老年患者纤维支气管镜检查术的效果［J］.中华麻醉学杂志，2013，33（1）：43-45.
［10］	柴薪，张丽娜，汲元美，等.不同剂量右美托咪定对丙泊酚复合瑞芬太尼用于整形外科手术患者麻醉效果的影响［J］.中华麻醉学杂志，2013，33（3）：306-310.
［11］	Kunisawa T，Nagashima M，Hanada S，et al.Awake intubation under sedation using target-controlled infusion of dexmedetomidine：five case reports［J］.JAnesth，2010，24（5）：789-792.
［12］	Menda F，Koner O，Sayin M，et al.Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotraeheal intubation in patients undergoing fasttrack CABG［J］.Ann Card Anaesth，2010，13（1）：16-21.
［13］	吴隆延，薛庆生.右美托咪定复合瑞芬太尼用于困难气道患者纤维支气管镜引导下经鼻清醒气管插管中的应用［J］.临床麻醉学杂志，2013，29（2）：166-168.
［14］	徐雪，梁治，董秋月，等.右美托咪定对困难气道患者经鼻插管应激反应的影响［J］.临床麻醉学杂志，2011，27（12）：1235-1236.
［15］	于红，张志捷.右美托咪定用于小儿气管异物取出术的麻醉观察［J］.实用医学杂志，2011，27（4）：669-671.
［16］	中华医学会麻醉学分会.右美托咪定临床应用指导意见（2013）［J］.中华麻醉学杂志，2013，33（10）：1165-1167.