小儿术中应用右美托咪定对苏醒室观察期呼吸的影响
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小儿术中应用右美托咪定对苏醒室观察期呼吸的影响
作者：王晓芳张锦
来源：《中国医药导报》2016年第13期
[摘要] 目的观察右美托咪定（Dex）对全身麻醉下行腺样体切除术的小儿在苏醒室观察期间呼吸、循环指标的影响，探讨Dex应用于患儿的安全性。方法选择2015年8～12月于中国医科大学附属盛京医院耳鼻咽喉科病房行全身麻醉下鼻内镜下腺样体切除术患儿50例为研究对象，采用随机数字表法将患儿分为对照组和右美托咪定组（Dex组），每组各25例。麻醉诱导、气管插管成功后，对照组给予生理盐水10 mL静脉泵入，Dex组给予Dex 0.4 μg/kg静脉泵入，给药时间为10 min。手术结束、拔出气管导管后，在患儿气道通畅、呼吸平稳后，送入苏醒室。患儿在苏醒室期间，如果呼吸空气，SpO2≤94%，则给予面罩吸氧。在苏醒室每5分钟记录1次患儿的呼吸频率、血氧饱和度、心率、血压、吸氧比例，及吸氧时间；记录患儿剧烈咳嗽、恶心、呕吐、躁动的发生率，及苏醒室的停留时间。结果与对照组比较，Dex组患儿在苏醒室的吸氧比例高于对照组，Dex组患儿的吸氧时间长于对照组，Dex组患儿的心率低于对照组，Dex组患儿苏醒室恶心、躁动的发生率低于对照组，Dex组患儿的苏醒室停留时间长于对照组，差异均有统计学意义（P < 0.05）。两组患儿在苏醒室的呼吸频率、血氧饱和度、血压、剧烈咳嗽和呕吐发生率比较，差异均无统计学意义（P > 0.05）。结论右美托咪定可在一定程度上抑制全身麻醉患儿在苏醒室观察期间的呼吸，降低患儿心率、恶心、躁动的发生率，延长患儿术后在苏醒室的停留时间。
[关键词] 右美托咪定；儿童；呼吸；苏醒室
[中图分类号] R971.2 [文献标识码] A [文章编号] 1673-7210（2016）05（a）-0052-05
[Abstract] Objective To observe the effect of Dexmedetomidine on respiration and circulation for the children undergoing adenoidectomy in postanesthesia care unit， and to discuss the safety of Dexmedetomidine applying to children. Methods Fifty children undergoing adenoidectomy under general anesthesia from August to December 2015 in Department of Otolaryngological， Shenjing Hospital of China Medical University were selected as the study objects， they were randomly divided into control group and Dexmedetomidine group （Dex group） according to the random number table method， 25 cases in each group. After anesthesia induction and tracheal intubation，control group received physiological saline 10 mL， Dex group was given Dexmedetomidine 0.4
μg/kg intravenously for 10 minutes. After extubation， the children with smooth breathing and unobstructed airway were sent to the recovery room. The oxygen was given to the children whose oxygen saturation ≤94% in the recovery room. The respi ratory rates， oxygen saturation， heart rates， blood pressure of the children were recorded every 5 minutes in the recovery room. In the recovery room， the proportion of children with oxygen， time of oxygen inhalation， and the