口腔医学研究 ›› 2019, Vol. 35 ›› Issue (1): 64-66.DOI: 10.13701/j.cnki.kqyxyj.2019.01.015

• 口腔颌面外科学研究 • 上一篇    下一篇

右美托咪定复合七氟烷吸入麻醉在日间儿童牙病治疗术中的应用

李术榕1*, 赵二贤2, 袁静静2   

  1. 1. 首都医科大学附属北京安贞医院麻醉中心 北京 100029;
    2. 郑州大学第一附属医院麻醉科 河南 郑州 450052
  • 收稿日期:2018-08-16 出版日期:2019-01-18 发布日期:2019-01-28
  • 通讯作者: 李术榕,E-mail:lishurong85@163.com
  • 作者简介:李术榕(1985~ ),女,山东聊城人,硕士,主治医师,研究方向:小儿苏醒期谵妄躁动。
  • 基金资助:
    国家自然科学基金青年基金(编号:81701097)

Application of Dexmedetomidine Combined with Sevoflurane Inhalation Anesthesia for Pediatric Dental Treatment

LI Shu-rong1*, ZHAO Er-xian2, YUAN Jing-jing2   

  1. 1. Anesthesia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
    2. Department of Anesthesia, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Received:2018-08-16 Online:2019-01-18 Published:2019-01-28

摘要: 目的:探讨适量右美托咪定复合七氟烷吸入麻醉在日间儿童牙病治疗手术的应用。方法:选择60名择期在日间门诊全身麻醉下行牙齿治疗术的儿童,随机均分为对照组(C组)和右美托咪定组(D组)。两组患儿均为七氟烷吸入诱导 ,D组麻醉后静脉输注右美托咪定负荷量 0.5 μg/kg ,后以0.5 μg/(kg·h)维持; C组给予等剂量生理盐水。吸入七氟烷维持麻醉,术中维持BIS 40~60。记录患儿术中心率(HR)、平均动脉压(MAP)及麻醉恢复时间和苏醒期躁动情况。结果:与C组比较,D组麻醉恢复期PAED躁动评分和m-CHEOPS疼痛评分明显低于C组;患儿苏醒时(T2)、拔管后5 min(T3)、拔管后10 min(T4)时D组MAP、HR差异有统计学意义。结论:右美托咪定复合七氟烷吸入麻醉可减少小儿苏醒期躁动和减轻术后疼痛,麻醉效果良好,适用于日间儿童牙病治疗术。

关键词: 右美托咪定, 七氟烷, 术后躁动

Abstract: Objective: To investigate the application of dexmedetomidine combined with sevoflurane inhalation anesthesia in pediatric dental caries. Methods: Sixty children who underwent extensive dental treatment under general anesthesia were randomly divided into control group (group C) and dexmedetomidine group (group D), with 30 cases in each group. All children were induced by sevoflurane. After anesthesia, the dexmedetomidine load was 0.5 μg/kg, and then maintained at 0.5 μg/(kg·h) in group D. However, group C was given an equal dose of normal saline. The children in group C was inhaled sevoflurane to maintain anesthesia and maintained BIS 40-60 during surgery. The incidence of heart rate (HR), mean arterial pressure (MAP), and recovery time of anesthesia and pediatric emergence delirium were recorded. Results: Compared with group C, the pediatric anesthesia emergence delirium (PAED) and modified Children’s Hospital of Eastern Ontario Pain Scale (m-CHEOPS) in group D were significantly lower than those in group C. There were significant differences in MAP and HR between group D at T2, T3 and T4. Conclusion: Dexmedetomidine combined with sevoflurane inhalation anesthesia can reduce pediatric emergence delirium and postoperative pain in children.

Key words: Dexmedetomidine, Sevoflurane, Postoperative delirium