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-  2018 

右美托咪定预注用于小儿全身麻醉诱导的安全性观察 Application of Dexmedetomidine for Induction of General Anesthesia in Children

Keywords: 右美托咪定,苏醒期躁动,全身麻醉,麻醉诱导室

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Abstract:

目的:评价右美托咪定预注用于小儿全身麻醉诱导的有效性及安全性。方法:将60名5-14岁拟行全身麻醉的儿童按照随机原则分为3组:对照组、右美托咪定低剂量诱导组、右美托咪定高剂量诱导组。进入手术室前,在诱导室监护仪监测及受试儿童在父母陪伴下,均接受微量泵静脉给予剂量为0.5μg/kg或1μg/kg的右美托咪定。所有患儿在手术室和麻醉后恢复室(PACU)中均监测心率(HR)、血氧饱和度(SpO2)及无创血压(NIBP)。同时记录麻醉诱导期开始、睫毛反射消失时间、停止使用吸入麻醉药、第一次睁眼以及气管内导管拔除等几个特定时刻的时间。患儿送入PACU后,在最初的30min内,每5min记录VAS评分和RSS评分以及苏醒期躁动发生情况及其程度,而在拔管后的30min内,每10 min记录上述结果。同时术后第2天测试患儿及家属满意度。结果:气管内导管拔除后,苏醒期躁动的发生率在高剂量右美托咪定组较之于与对照组差异有统计学意义(P<0.05)。在拔管时以及其后的5min和10min,3组的VAS评分和RSS评分差异均具有统计学意义(P<0.05)。右美托咪定组患者满意度及家长满意度均显著高于正常对照组(P<0.05)。结论:不同剂量右美托咪定预注能安全有效地用于小儿全身麻醉诱导,能够显著降低患儿苏醒期的躁动,同时能够减少患儿恐惧感并增加患儿及家属满意度

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