右美托咪定复合布比卡因骶管阻滞对预防七氟醚小儿麻醉苏醒期躁动的观察分析(1)
摘 要：目的 右美托咪定复合布比卡因骶管阻滞预防小儿七氟醚麻醉术后苏醒期躁动的效果。方法 选择2～6岁择期行疝、鞘膜积液、尿道下裂，隐睾手术治疗的患儿60例。所有患儿均为ASA1级，均行骶管阻滞，随机分为两组，每组30例，B-D组行0.25%布比卡因复合1.5 μg/kg右美托咪定骶管阻滞；B组单纯应用0.25%布比卡因行骶管阻滞。比较两组患儿术后PAED评分、FLACC疼痛评分及脸谱疼痛评分。记录麻醉诱导前，骶管阻滞前，骶管阻滞后每隔10 min的HR、MAP、SpO2、ETCO2。结果 两组患儿T1～T6期间HR、MAP、SpO2差异，无统计学意义(P>0.05)。B组呼气末七氟醚浓度(1.93±0.33)vol%高于B-D组(1.22±0.21)vol%，差异有统计学意义(P<0.05)。B-D组术后脸谱疼痛评分、FLACC 评分及PAED评分优于B组，差异具有统计学意义(P<0.05)。结论 右美托咪定复合布比卡因骶管阻滞能有效减少七氟醚小儿麻醉苏醒期躁动发生。
关键词：小儿；右美托咪定；七氟醚；躁动
, http://www.100md.com
中图分类号：R726.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.024
文章编号：1006-1959(2018)08-0078-03
Observation of Dexmedetomidine Combined with Bupivacaine Caudal Block in Preventing Sedation in Children with Sevoflurane during Anesthesia Recovery Period
WANG Xu-fei，LIANG Yong-xin
(Department of Anesthesiology，Affiliated Hospital of Medical College，Qingdao University，Qingdao 266003，Shandong，China)
, 百拇医药
Abstract：Objective To observe the effect of dexmedetomidine combined with bupivacaine caudal block in preventing postoperative restlessness after sevoflurane anesthesia in children.Methods Select 2 to 6-year-old elective cramps，hydrocele，hypospadias， cryptorchidism in 60 cases of children treated.All patients were ASA grade 1 and all received sacral canal block.They were randomly divided into two groups，30 in each group.Group B-D received 0.25% bupivacaine combined with 1.5μg/kg dexmedetomidine for sacral block，while group B used 0.25% bupivacaine alone for sacral block.Postoperative PAED score，FLACC pain score and facial pain score were compared between the two groups.HR，MAP，SPO2 and ETCO2 were recorded every 10 min before sacral block before anesthesia induction.Results There was no significant difference in HR，MAP and SpO2 between the two groups during T1～T6(P>0.05).The concentration of end tidal sevoflurane in group B(1.93+0.33)vol% was higher than that in group B-D(1.22+0.21)vol%，the difference was statistically significant(P<0.05).Postoperative pain score，FLACC score and PAED score in group B-D were better than those in group B，and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with bupivacaine sacral block can effectively reduce the incidence of restlessness in children with sevoflurane during anesthesia recovery period.
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Key words：Children；Dexmetidine；Sevoflurane；Restlessness
小兒麻醉苏醒期躁动表临床危害很大，容易造成患儿坠床，挠抓，拔出重要管路等自身伤害，增加术后并发症发生，同时也引起患儿家属的担忧和不满。如何减少小儿麻醉苏醒期躁动发生一直是我们临床麻醉关注的重点。七氟醚麻醉因诱导迅速，呼吸道刺激小等优点，目前广泛用于小儿麻醉诱导及维持。但是，其苏醒期躁动发生率高。如何降低小儿苏醒期躁动的发生需要我们深入研究。右美托咪定是一种有效的选择性α-2肾上腺素兴奋剂，作为辅助药物应用于小儿麻醉已越来越受欢迎，特别是在延长骶管镇痛持续时间方面。本次研究主要就小儿疝、鞘膜积液、尿道下裂、隐睾手术作研究，右美托咪定复合布比卡因骶管阻滞比单纯应用布比卡因骶管阻滞能使小儿七氟醚麻醉术后苏醒期躁动的发生率，现分析如下。, 百拇医药(王绪飞 梁永新)
关键词：小儿；右美托咪定；七氟醚；躁动
, http://www.100md.com
中图分类号：R726.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.024
文章编号：1006-1959(2018)08-0078-03
Observation of Dexmedetomidine Combined with Bupivacaine Caudal Block in Preventing Sedation in Children with Sevoflurane during Anesthesia Recovery Period
WANG Xu-fei，LIANG Yong-xin
(Department of Anesthesiology，Affiliated Hospital of Medical College，Qingdao University，Qingdao 266003，Shandong，China)
, 百拇医药
Abstract：Objective To observe the effect of dexmedetomidine combined with bupivacaine caudal block in preventing postoperative restlessness after sevoflurane anesthesia in children.Methods Select 2 to 6-year-old elective cramps，hydrocele，hypospadias， cryptorchidism in 60 cases of children treated.All patients were ASA grade 1 and all received sacral canal block.They were randomly divided into two groups，30 in each group.Group B-D received 0.25% bupivacaine combined with 1.5μg/kg dexmedetomidine for sacral block，while group B used 0.25% bupivacaine alone for sacral block.Postoperative PAED score，FLACC pain score and facial pain score were compared between the two groups.HR，MAP，SPO2 and ETCO2 were recorded every 10 min before sacral block before anesthesia induction.Results There was no significant difference in HR，MAP and SpO2 between the two groups during T1～T6(P>0.05).The concentration of end tidal sevoflurane in group B(1.93+0.33)vol% was higher than that in group B-D(1.22+0.21)vol%，the difference was statistically significant(P<0.05).Postoperative pain score，FLACC score and PAED score in group B-D were better than those in group B，and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with bupivacaine sacral block can effectively reduce the incidence of restlessness in children with sevoflurane during anesthesia recovery period.
, http://www.100md.com
Key words：Children；Dexmetidine；Sevoflurane；Restlessness
小兒麻醉苏醒期躁动表临床危害很大，容易造成患儿坠床，挠抓，拔出重要管路等自身伤害，增加术后并发症发生，同时也引起患儿家属的担忧和不满。如何减少小儿麻醉苏醒期躁动发生一直是我们临床麻醉关注的重点。七氟醚麻醉因诱导迅速，呼吸道刺激小等优点，目前广泛用于小儿麻醉诱导及维持。但是，其苏醒期躁动发生率高。如何降低小儿苏醒期躁动的发生需要我们深入研究。右美托咪定是一种有效的选择性α-2肾上腺素兴奋剂，作为辅助药物应用于小儿麻醉已越来越受欢迎，特别是在延长骶管镇痛持续时间方面。本次研究主要就小儿疝、鞘膜积液、尿道下裂、隐睾手术作研究，右美托咪定复合布比卡因骶管阻滞比单纯应用布比卡因骶管阻滞能使小儿七氟醚麻醉术后苏醒期躁动的发生率，现分析如下。, 百拇医药(王绪飞 梁永新)