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麻醉诱导期右美托咪定滴鼻在患儿中的镇静及躁动研究 被引量:19

Study of Postoperative Sedation and Emergence Delirium in Children with Intranasal Dexmedetomidine during Anesthesia Induction
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摘要 探究麻醉诱导期右美托咪定滴鼻对患儿术中及术后的镇静效果。择期手术患儿60例,随机分为3组,D1组、D2组和C组,麻醉诱导期分别给予1.0μg/kg右美托咪定滴鼻,2.0μg/kg右美托咪定滴鼻和等量生理盐水滴鼻。结果三组滴鼻前时刻T0血流动力学无差异(P>0.05),滴鼻后45min时刻(T1)和拔出导管或喉罩时刻(T2)D1组与D2组较C组心率和血压低(P<0.05),但在允许范围内;T1、T2时刻,D1组与D2组差异不明显(P>0.05);术后躁动评分,D1组与D2组较C组低(P<0.05),D2组较D1组低(P<0.05);术后疼痛评分,D1组与D2组较C组低(P<0.05),D1组与D2组差异无统计学意义(P>0.05);术后镇痛需求,D1组与D2组较C组少(P<0.05);不良反应无差异(P>0.05)。麻醉诱导期右美托咪定滴鼻起到有效镇静作用,减少麻醉苏醒期躁动,减轻疼痛。2.0μg/kg的右美托咪定剂量麻醉诱导期滴鼻减少术后躁动效果更明显,不增加不良反应的发生。 The aim of this study was to investigate the effect of intranasal dexmedetomidine on postoperative sedation and emergence delirium in children during anesthesia induction.60 infants with general anesthesia,aged from 3years old to 6years old,were randomly divided into three groups,namely group D1,group D2,group C,received intranasal dexmedetomidine 1.0μg/kg,2.0μg/kg,normal saline solution twice in each nostril.There was no significantly difference at T0 time among the three groups in HR and BP,and at T1 and T2time between group D1 and group D2(P〉0.05);HR and BP of group D1 and group D2 were significantly lower than group C at T1 and T2time(P〈0.05).Delirium scores of group D1 and group D2 were significantly lower than group C(P〈0.05);Delirium scores of group D2 were significantly lower than group D1(P〈0.05);pain scores of group D1 and group D2 were significantly lower than group C(P〈0.05);There was no significant difference in pain scores between group D1 and group D2(P 〉0.05).The children needed postoperative analgesics of group D1 and group D2 were less than group C(P〈0.05).There was no significantly difference in adverse reactions among three groups(P〉0.05).These results suggested that intranasal administration of dexmedetomidine had good effect of sedation,and reducing emergence delirium and postoperative pain.Intranasal administration of 2.0μg/kg dexmedetomidine is more effective,and not increasing the incidence of adverse reactions.
出处 《医学与哲学(B)》 2014年第12期50-52,共3页 Medicine & Philosophy(B)
关键词 麻醉诱导期 右美托咪定滴鼻 小儿 术后镇静 术后躁动 anesthesia induction, intranasal dexmedetomidine, paediatric, postoperative sedation, emergence delirium
作者简介 赵京伟(1987-),男,山东临沂人,硕士研究生,研究方向:麻醉基础与临床。 通讯作者:韩雪萍(1958-),女,河南郑州人,主任医师,教授,博士生导师,研究方向:麻醉基础与临床。E-mail:hanxueping66@sina.com
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参考文献12

  • 1张加强,孟凡民,侯艳华,索晓燕.右旋美托咪啶对小儿七氟醚麻醉苏醒期躁动及血流动力学的影响[J].临床麻醉学杂志,2010,26(7):627-628. 被引量:106
  • 2李彩云,朱蓉,方敏,唐世芳.疼痛评估量表在癌症疼痛病人中的应用[J].全科护理,2010,8(28):2554-2555. 被引量:28
  • 3Przybylo H J, Martini D R, Mzzurek A J, et al. Asessing behaviour in children emerging from anaesthesia:can we aplly psychiateic di- agnostic teehnigues[J]. Paediatr Anaesth, 2003,13(7) : 609- 616.
  • 4Hallen J,Rawal N, Gupta A. Postoperative recovery following out- patient pediatric myringotomy: a comparison between sevoflurane and halothane[J]. J Clin Anesth,2001,13(3) :161-166.
  • 5Yuen V M, Hui T W, Irwin M G, et al. A randomised comparison of two intranasal dexmedetomidine doses for premedication in children [J]. Anaesthesia,2012,67(11) :1210-1216.
  • 6Iirola T, Vilo S, Manner T, et al, Bioavailability of dexmedetomidine after intranasal administration[J]. Eur J Clin Pharmacol, 2011,67 (8) :825-831.
  • 7Yuen V M,Hui T W,Irwin M G,et al. Optimal timing for the ad- ministration of intranasal dexmedetomidine for premedication in children[J]. Anaesthesia, 2010,65 (9) : 922- 929.
  • 8Kunisawa T, Nagata O, Ogasawara H, et al. Anesthetic manage ment of awake coronary artery bypass grafting usingdexmedetomi dine-high-dose administration and pharmacokinetic simulation [J]. Masui,2006,55(10) :1238- 1242.
  • 9韩梅,侯东男.癫痫手术大脑皮层脑电图监测期间麻醉深度变化与术中知晓的临床观察[J].大连医科大学学报,2013,35(1):61-64. 被引量:4
  • 10倪红伟,张瑛,史东平.右美托咪定在全身麻醉中的应用[J].医学与哲学(B),2013,34(6):73-76. 被引量:17

二级参考文献28

  • 1Malviya S,Voepel-Lewis T,Ramamurthi RJ,et al.Clonidine for the prevention of emergence agitation in young children:efficacy and recovery profile.Paediatr Anaesth,2006,16:554-559.
  • 2Aono J,Ueda W,Mamiya K,et al.Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys.Anesthesiology,1997,87:1298-1300.
  • 3Davis PJ,Greenberg JA,Gendelman M,et al.Recovery characteristics of sevoflurane and halothane in preschool-aged children undergoing bilateral myringntomy and pressure equalization tube insertion.Anesth Analg,1999,88:34-38.
  • 4Millar K,Asbury AJ,Bowman AW,et al.A randomised placebo-controlled trial of the effects of midazolam premedication on children's postoperative cognition.Anaesthesia,2007,62:923-930.
  • 5Tazeroualti N,De Groote F,De Hen S,et al.Oral clonidine vs midazolam in the prevention of sevoflurane-induced agitation in children,a prospective,randomized,controlled trial.Br J Anaesth,2007,98:667-671.
  • 6Dyck JB,Maze M,Haack C,et al.The pharmacokinetics and hemodynamic effects of intravenous and intramuscular dexmedetomidine hydrochloride in adult human volunteers.Anesthesiology,1993,78:813-820.
  • 7Tobias JD,Berkenbosch JW.Initial experience with dexmedetomidine in paediatric-aged patients.Paediatr Anaesth,2002,12:171-175.
  • 8Cleve LV,Bossert EA,Savedra MC.Scientific inquiry:Cancer pain in children:The selection of a model to guide research[J].Journal for Specialists in Pediatric Nursing,2002,7(4):163-165.
  • 9Merboth MK,Barnason S.Managing pain:The fifth vital sign[J].Nurs Clin North Am,2000,35(2):375-383.
  • 10Russell IF. Midazolam- alfentanil: an anaesthetic? An in- vestigation using the isolated forearm technique [ J ]. Br J Anaesth, 1993,70 ( 1 ) :42 - 46.

共引文献170

同被引文献110

  • 1杨建,张玲英,彭琼.对小儿进行静脉麻醉的研究进展[J].当代医药论丛,2014,12(5):1-2. 被引量:3
  • 2Beebe DS, Belani KG, Ch^ig PN, et al. Effectiveness of preoperalive犹dation vrith 敗tal tnidsoolam,ketamine, or their combination in ytningcWldren [ J], Anesth Analg, 1992 , 75 ( 6) ; 880 - 884.
  • 3孙培丹.小儿麻醉诱导期舒芬太尼对丙泊酚镇静作用的影响研究[J].大家健康:下旬版,2014, 8 (20): 541.
  • 4Lin CS,Sun WZ,Chan WH,et al.Intravenous lidocaine and ephedrine,but not propofol,suppress fentanyl-induced cough. Canadian Journal of Anesthesia . 2004
  • 5Yushi U Adachi,Isao Takamatsu,Kazuhiko Watanabe,Yoshitaka Uchihashi,Hideyuki Higuchi,Tetsuo Satoh.??Evaluation of the cardiovascular responses to fiberoptic orotracheal intubation with television monitoring: comparison with conventional direct laryngoscopy(J)Journal of Clinical Anesthesia . 2000 (7)
  • 6陈喜炎,邵伟.??全麻诱导气管插管致心跳骤停1例(J)潍坊医学院学报. 2001(01)
  • 7Kwak H J,Min S K,Kim J S,Kim J Y.Prevention of propofol-induced pain in children: combination of alfentanil and lidocaine vs alfentanil or lidocaine alone. British journal of anaesthesia . 2009
  • 8J. Yu,Y. Lu,C. Dong,H. Zhu,R. Xu.??Premedication with intravenous dexmedetomidine–midazolam suppresses fentanyl-induced cough(J)Irish Journal of Medical Science . 2012 (4)
  • 9许文妍,张马忠.七氟烷在小儿麻醉中的应用[J].上海医学,2010,33(6):509-512. 被引量:16
  • 10张加强,孟凡民,侯艳华,索晓燕.右旋美托咪啶对小儿七氟醚麻醉苏醒期躁动及血流动力学的影响[J].临床麻醉学杂志,2010,26(7):627-628. 被引量:106

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