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目的观察右美托咪定对小儿扁桃体切除术全麻拔管期血流动力学及苏醒质量的影响。方法择期行双侧扁桃体切除术患儿60例,随机分为两组,每组30例。麻醉诱导插管后,右美托咪定组给予右美托咪定0.5μg·kg~(-1),10 min泵完,对照组泵注等量氯化钠注射液。两组其他麻醉方法相同。监测患儿入室时(T_0)、术毕(T_1)、拔管时(T_2)、拔管后2 min(T_3)、拔管后5 min(T_4)、拔管后10 min(T_5)各时点的平均动脉压(MAP)和心率(HR),记录睁眼时间及拔管时间。记录术毕患儿恶心、呕吐情况,并评估患儿躁动发生率。结果T_0时,两组MAP和HR无显著差异(P>0.05)。T_1—T_5各时点右美托咪定组MAP和HR显著低于对照组(P<0.05)。两组睁眼时间及拔管时间无显著差异(P>0.05)。右美托咪定组发生术后躁动5例,恶心、呕吐3例,对照组分别为16例和10例,右美托咪定组躁动发生率及恶心、呕吐发生率均低于对照组(P<0.05)。结论右美托咪定能使小儿扁桃体切除术后拔管时血流动力学更加平稳,并有效减少术后躁动及恶心、呕吐的发生,且不影响麻醉苏醒时间。
Objective To observe the effect of dexmedetomidine on the hemodynamics and wakefulness of children during tonsillectomy. Methods Sixty children with bilateral tonsillectomy were randomly divided into two groups (n = 30 in each group). After anesthesia induced intubation, dexmedetomidine group was given dexmedetomidine 0.5μg · kg ~ (-1) for 10 min, and the control group was given the same amount of sodium chloride injection. The other two methods of anesthesia the same. The T_0, T_1, T_2, T 2, T 5, T 5, T 10, T 5, Point of mean arterial pressure (MAP) and heart rate (HR), recording open time and extubation time. Record patients with nausea and vomiting, and assess the incidence of agitation in children. Results T_0, MAP and HR no significant difference between the two groups (P> 0.05). The MAP and HR in dexmedetomidine group at T_1-T_5 were significantly lower than those in control group (P <0.05). There were no significant differences between the two groups in the time to open eyes and the extubation time (P> 0.05). Dexmedetomidine group postoperative agitation in 5 cases, nausea and vomiting in 3 cases, the control group were 16 cases and 10 cases, the incidence of agitation and nausea and vomiting dexmedetomidine group were lower than the control group ( P <0.05). Conclusion Dexmedetomidine can make hemodynamics more stable after extubation in children with tonsillectomy and effectively reduce post-operative agitation and nausea and vomiting without affecting anesthesia recovery time.