右美托咪定与神经阻滞麻醉联合在65例小儿全身麻醉中的效果(1)
摘 要 目的：探讨右美托咪定与神经阻滞麻醉联合在小儿全身麻醉中的应用效果。方法：选取130例行腹股沟区手术患儿根据不同的麻醉方式分为对照组和研究组各65例，对照组给予右美托咪定静脉全麻诱导，研究组此基础上联合神经阻滞，比较两组不同麻醉时间点各麻醉指标变化、术后不同时间点VAS评分及麻醉效果。结果：麻醉诱导前、麻醉后及苏醒时两组平均动脉压(mean arterial pressure， MAP)、心率(heart rate， HR)及血氧饱和度(SpO2)比较无显著性差异；研究组切皮时MAP、HR值，术后不同时间点VAS评分及躁动评分及躁动发生率显著低于对照组、但苏醒时间长于对照组(P<0.05)。结论：右美托咪定联合神经阻滞麻醉有助于减轻术后疼痛及患儿躁动，麻醉效果较好。
关键词 右美托咪定 神经阻滞 小儿 全身麻醉 躁动 VAS评分
中图分类号：R614.4； R726.1 文献标志码：A 文章编号：1006-1533(2018)07-0033-03
Effect of dexmedetomidine combined with nerve block anesthesia on 65 cases of children undergoing general anesthesia
CHEN Wenjuan， WEI Bing*
(Department of Anesthesiology， Kaizhou People’s Hospital， Chongqing 405400， China)
ABSTRACT Objective： To explore the effects of dexmedetomidine plus nerve block anesthesia on children undergoing general anesthesia. Methods： One hundred and thirty children undergoing selective inguinal surgery were selected and divided into a control group and a study group with 65 cases each based on different anesthesia methods. The control group underwent intravenous general anesthesia with dexmedetomidine while the study group was given nerve block anesthesia besides dexmedetomidine. The changes of anesthesia indexes at different anesthesia time points and the VAS scores and anesthetic effects at different postoperative time points were compared between the two groups. Results： Comparison of mean arterial pressure (MAP)， heart rate (HR) and SpO2 between the two groups showed no significant differences before anesthetic induction， after anesthesia and at wake-up (P>0.05). MAP and HR values at skin incision and VAS scores， sedation-agitation scale and restlessness incidence at the different postoperative time points were significant lower， however the time for wake-up was longer in the study group than in the control group (P<0.05). Conclusion： Dexmedetomidine combined with nerve block anesthesia is helpful to relieve postoperative pain and restlessness and possesses a good effect of anesthesia.
KEy WORDS dexmedetomidine； nerve block anesthesia； children； general anesthesia； restlessness； VAS score
目前，臨床上不仅注重全身麻醉的效果，而且对减轻术后疼痛及麻醉恢复期并发症也提出了更高的要求，最大限度保证手术效果，促进术后恢复[1]。小儿生理功能及机体组织结构发育尚未完全，因其生理特性在实施全身麻醉时限制及要求较高，常规的药物静脉全麻诱导常难以满足手术要求，且术后镇痛效果不佳，麻醉恢复期易产生躁动等并发症，影响术后恢复[2]。小儿腹股沟区手术要求手术时间短、刺激小、诱导迅速、并发症少、安全性高。有研究表明，在静脉全麻诱导的基础上联合神经阻滞可有效提高麻醉效果，减少术后并发症[3]。本研究选取130例行腹股沟区手术患儿为研究对象，探讨右美托咪定与神经阻滞麻醉联合在小儿全身麻醉中的应用效果。
1 资料与方法
1.1 一般资料
选取2015年9月—2017年9月我院130例行腹股沟区手术患儿为研究对象，所有患儿均符合单侧腹股沟手术的诊断标准[4]，于全身麻醉下实施手术，患儿家属知情同意，自愿签署手术知情同意书，且排除心血管疾病、肝肾功能障碍、神经系统疾病、呼吸系统疾病、凝血功能障碍、药物过敏史及其他手术禁忌证者。根据不同的麻醉方式将入选的患儿分为对照组和研究组各65例，对照组中男35例，女30例，年龄1～7岁，平均(3.45±1.26)岁；体质量9～24 kg，平均(16.87±2.64)kg；研究组中男36例，女29例，年龄1～6岁，平均(3.85±1.12)岁；体质量9～23 kg，平均(17.12±2.16)kg。两组患儿的一般资料对比，不存在显著差异性(P>0.05)，可进行对比分析。, 百拇医药(陈文娟 韦兵)
关键词 右美托咪定 神经阻滞 小儿 全身麻醉 躁动 VAS评分
中图分类号：R614.4； R726.1 文献标志码：A 文章编号：1006-1533(2018)07-0033-03
Effect of dexmedetomidine combined with nerve block anesthesia on 65 cases of children undergoing general anesthesia
CHEN Wenjuan， WEI Bing*
(Department of Anesthesiology， Kaizhou People’s Hospital， Chongqing 405400， China)
ABSTRACT Objective： To explore the effects of dexmedetomidine plus nerve block anesthesia on children undergoing general anesthesia. Methods： One hundred and thirty children undergoing selective inguinal surgery were selected and divided into a control group and a study group with 65 cases each based on different anesthesia methods. The control group underwent intravenous general anesthesia with dexmedetomidine while the study group was given nerve block anesthesia besides dexmedetomidine. The changes of anesthesia indexes at different anesthesia time points and the VAS scores and anesthetic effects at different postoperative time points were compared between the two groups. Results： Comparison of mean arterial pressure (MAP)， heart rate (HR) and SpO2 between the two groups showed no significant differences before anesthetic induction， after anesthesia and at wake-up (P>0.05). MAP and HR values at skin incision and VAS scores， sedation-agitation scale and restlessness incidence at the different postoperative time points were significant lower， however the time for wake-up was longer in the study group than in the control group (P<0.05). Conclusion： Dexmedetomidine combined with nerve block anesthesia is helpful to relieve postoperative pain and restlessness and possesses a good effect of anesthesia.
KEy WORDS dexmedetomidine； nerve block anesthesia； children； general anesthesia； restlessness； VAS score
目前，臨床上不仅注重全身麻醉的效果，而且对减轻术后疼痛及麻醉恢复期并发症也提出了更高的要求，最大限度保证手术效果，促进术后恢复[1]。小儿生理功能及机体组织结构发育尚未完全，因其生理特性在实施全身麻醉时限制及要求较高，常规的药物静脉全麻诱导常难以满足手术要求，且术后镇痛效果不佳，麻醉恢复期易产生躁动等并发症，影响术后恢复[2]。小儿腹股沟区手术要求手术时间短、刺激小、诱导迅速、并发症少、安全性高。有研究表明，在静脉全麻诱导的基础上联合神经阻滞可有效提高麻醉效果，减少术后并发症[3]。本研究选取130例行腹股沟区手术患儿为研究对象，探讨右美托咪定与神经阻滞麻醉联合在小儿全身麻醉中的应用效果。
1 资料与方法
1.1 一般资料
选取2015年9月—2017年9月我院130例行腹股沟区手术患儿为研究对象，所有患儿均符合单侧腹股沟手术的诊断标准[4]，于全身麻醉下实施手术，患儿家属知情同意，自愿签署手术知情同意书，且排除心血管疾病、肝肾功能障碍、神经系统疾病、呼吸系统疾病、凝血功能障碍、药物过敏史及其他手术禁忌证者。根据不同的麻醉方式将入选的患儿分为对照组和研究组各65例，对照组中男35例，女30例，年龄1～7岁，平均(3.45±1.26)岁；体质量9～24 kg，平均(16.87±2.64)kg；研究组中男36例，女29例，年龄1～6岁，平均(3.85±1.12)岁；体质量9～23 kg，平均(17.12±2.16)kg。两组患儿的一般资料对比，不存在显著差异性(P>0.05)，可进行对比分析。, 百拇医药(陈文娟 韦兵)