右美托咪定对肱骨髁上骨折患儿手法复位术后七氟醚麻醉苏醒期躁动影响的临床观察(1)
[摘要] 目的 探讨右美托咪定对肱骨髁上骨折患儿手法复位术后七氟醚麻醉苏醒期躁动的影响。 方法 选取本院收治的肱骨髁上骨折患儿72例，分为右美托咪定组和对照组，两组术前常规禁食、禁饮4 h。麻醉前10 min静脉注射咪达唑仑0.1 mg/kg，盐酸戊乙奎醚0.01 mg/kg；常规监测BP、RR、HR、SpO2，并检测脑电双频谱指数(BIS)；然后进行麻醉诱导，麻醉诱导成功后行气管插管，并连接呼吸机，采用PCV模式行机械通气。右美托咪定组在麻醉诱导前10 min静脉输注右美托咪定，对照组予以等容量生理盐水。两组给药结束后即可开始手法复位，两组患儿术中吸入2%～4%七氟醚以维持麻醉，BIS值保持在45～60。观察两组患儿手法复位时间、拔管时间、麻醉时间、苏醒时间、七氟醚用量、呼气末七氟醚浓度、躁动发生率、苏醒期评分以及两组患儿不同时点血糖和血清皮质醇浓度。 结果 与对照组比较，右美托咪定组拔管时间、苏醒时间明显缩短，七氟醚用量减少，呼气末七氟醚浓度、躁动发生率、血糖和血清皮质醇浓度以及苏醒期评分明显降低，差异有统计学意义(P<0.05)。 结论 右美托咪定对肱骨髁上骨折患儿手法复位术后七氟醚麻醉苏醒期躁动可产生可靠的麻醉效应，且未发生不良反应，值得推广应用。
[关键词] 右美托咪定；七氟醚；麻醉
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2015)01(b)-0069-04
Clinical observation about effect of dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after operation of manipulative reduction in children with supracondylar fracture
ZENG Jun-hua
Department of Anesthesiology，Chinese Traditional Medical Hospital of Shenzhen City，Shenzhen 518033，China
[Abstract] Objective To investigate the effect of dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after operation of manipulative reduction in children with supracondylar fracture. Methods 72 children with supracondylar fracture were selected and divided into dexmedetomidine group and control group.Routine preoperative forbidden to fast and forbidden to drink 4 hours were used in two groups.Before anesthesia of 10 min，intravenous midazolam 0.1 mg/kg and penehyclidine hydrochloride 0.01 mg/kg were applied.Routine BP，RR，HR，SpO2 were monitored and bispectral index(BIS)was detected.Anesthesia was induced successfully underwent endotracheal intubation，and connected to a respirator，PCV mode mechanical ventilation was used.Before induction anesthesia of 10 min，intravenous infusion dexmedetomidine was used in dexmedetomidine group，the same volume of saline was applied in control group.Manipulative reduction was applied after the end of dosing.Two groups of children intraoperative inhaled 2%-4% sevoflurane to maintain anesthesia.BIS value was maintained at 45 to 60.Practice reset time，extubation time，anesthesia time， ecovery time，the amount of gas isoflurane，end-tidal sevoflurane concentration，incidence rate of restlessness，recovery period score，different points glucose and serum cortisol concentration were observed. Results Compared with control group，extubation time，recovery time in dexmedetomidine group was significantly shorter respectively(P<0.05).Compared with control group，the isoflurane gas consumption，end-tidal sevoflurane concentration，incidence rate of restlessness，glucose and serum cortisol concentration，recovery period score was significantly lower respectively，with statistical difference(P<0.05). Conclusion Dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after operation of manipulative reduction in children with supracondylar fracture has reliable anesthetic effect，has no produce adverse reaction.So it is worthy of promotion and application. (曾俊华)
[关键词] 右美托咪定；七氟醚；麻醉
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2015)01(b)-0069-04
Clinical observation about effect of dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after operation of manipulative reduction in children with supracondylar fracture
ZENG Jun-hua
Department of Anesthesiology，Chinese Traditional Medical Hospital of Shenzhen City，Shenzhen 518033，China
[Abstract] Objective To investigate the effect of dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after operation of manipulative reduction in children with supracondylar fracture. Methods 72 children with supracondylar fracture were selected and divided into dexmedetomidine group and control group.Routine preoperative forbidden to fast and forbidden to drink 4 hours were used in two groups.Before anesthesia of 10 min，intravenous midazolam 0.1 mg/kg and penehyclidine hydrochloride 0.01 mg/kg were applied.Routine BP，RR，HR，SpO2 were monitored and bispectral index(BIS)was detected.Anesthesia was induced successfully underwent endotracheal intubation，and connected to a respirator，PCV mode mechanical ventilation was used.Before induction anesthesia of 10 min，intravenous infusion dexmedetomidine was used in dexmedetomidine group，the same volume of saline was applied in control group.Manipulative reduction was applied after the end of dosing.Two groups of children intraoperative inhaled 2%-4% sevoflurane to maintain anesthesia.BIS value was maintained at 45 to 60.Practice reset time，extubation time，anesthesia time， ecovery time，the amount of gas isoflurane，end-tidal sevoflurane concentration，incidence rate of restlessness，recovery period score，different points glucose and serum cortisol concentration were observed. Results Compared with control group，extubation time，recovery time in dexmedetomidine group was significantly shorter respectively(P<0.05).Compared with control group，the isoflurane gas consumption，end-tidal sevoflurane concentration，incidence rate of restlessness，glucose and serum cortisol concentration，recovery period score was significantly lower respectively，with statistical difference(P<0.05). Conclusion Dexmedetomidine on restlessness during sevoflurane anesthesia recovery period after operation of manipulative reduction in children with supracondylar fracture has reliable anesthetic effect，has no produce adverse reaction.So it is worthy of promotion and application. (曾俊华)