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目的探讨右旋美托咪定用于小儿脊柱侧弯术中唤醒的临床效果。方法选取2013年6月—2014年6月山东大学第二医院收治的进行择期脊柱侧弯矫正术的患儿50例,随机分为观察组与对照组,各25例。两组均给予全凭静脉麻醉,此外在唤醒期观察组给予右旋美托咪定维持,对照组患儿给予常用剂量的0.9%氯化钠溶液维持。比较两组患儿唤醒前10min、自主呼吸恢复时、唤醒即刻及唤醒后10min的心率(HR)、平均动脉压(MAP)及脑电双频指数(BIS);比较两组患儿唤醒时间及唤醒质量、躁动情况。结果两组患儿唤醒时刻HR与MAP均高于唤醒前10min,对照组高于观察组,差异有统计学意义(P<0.05);两组患儿不同时间点BIS比较,差异无统计学意义(P>0.05);两组患儿的唤醒时间比较,差异无统计学意义(P>0.05);观察组唤醒质量高于对照组,躁动发生率低于对照组,差异有统计学意义(P<0.05)。结论小儿脊柱侧弯术中使用右旋美托咪定维持,其唤醒期间血流动力学平稳,对唤醒时间无明显延迟,且唤醒质量较高,躁动发生率低。
Objective To investigate the clinical effect of dexmedetomidine in arousal of pediatric scoliosis. Methods Fifty children with elective scoliosis corrected at the Second Hospital of Shandong University from June 2013 to June 2014 were randomly divided into observation group and control group, with 25 cases in each group. Both groups were given total intravenous anesthesia. In addition, dexmedetomidine was given to the observation group during awake period and 0.9% sodium chloride solution was administered to the control group. Heart rate (HR), mean arterial pressure (MAP) and bispectral index (BIS) were compared between the two groups before 10 minutes of awake, spontaneous respiration, immediately after awakening and 10 minutes after awakening. Awaken quality, restlessness. Results HR and MAP in both groups were significantly higher than those in the control group (10 and 10 minutes before awake), and the difference was statistically significant (P <0.05). There was no significant difference in BIS between two groups at different time points (P> 0.05). There was no significant difference in wake-up time between the two groups (P> 0.05). The awakening quality of the observation group was higher than that of the control group, and the incidence of agitation was lower than that of the control group <0.05). Conclusions Dexmedetomidine is used to maintain pediatric scoliosis. Hemodynamics is stable during awakening, there is no obvious delay in wake-up time, and the wake-up quality is high and the incidence of agitation is low.