• 1 徐州市銅山區(qū)大許鎮(zhèn)中心衛(wèi)生院麻醉科（江蘇徐州，221124）;2徐州醫(yī)學(xué)院附屬醫(yī)院麻醉科;

目的 　探討右美托咪定對(duì)小兒七氟烷吸入麻醉蘇醒期躁動(dòng)的影響。 方法 　選擇2011年3月－2012年1月美國麻醉醫(yī)師協(xié)會(huì)分級(jí)Ⅰ～Ⅱ級(jí)、年齡2～8歲、擇期行疝囊高位結(jié)扎術(shù)和隱睪下降固定術(shù)患兒40例，隨機(jī)分為2組，右美托咪定組（A組）和對(duì)照組（B組），兩組患兒在年齡、體重、手術(shù)種類無明顯差異。兩組患兒均采用面罩8%七氟烷吸入麻醉誘導(dǎo)，開放靜脈，給予鹽酸戊乙奎醚0.1 mg/kg、順式阿曲庫銨0.15 mg/kg，插入喉罩，麻醉維持根據(jù)血壓、心率及腦電雙頻指數(shù)調(diào)節(jié)吸入麻醉藥濃度。A組靜脈給予1 μg/kg右美托咪定，B組給予同等容量的生理鹽水。入室至手術(shù)結(jié)束時(shí)連續(xù)觀察收縮壓、舒張壓、心率、血氧飽和度，記錄清醒時(shí)間、拔除喉罩時(shí)間，記錄蘇醒期并發(fā)癥的發(fā)生數(shù)。記錄入麻醉恢復(fù)室即刻（0 min）、15、30、60、90 min患兒疼痛和躁動(dòng)評(píng)分。 結(jié)果 　兩組患兒在手術(shù)時(shí)間、清醒時(shí)間以及拔除喉罩時(shí)間差異無統(tǒng)計(jì)學(xué)意義（P＞0.05），A組術(shù)后入恢復(fù)室0、15、30 min疼痛評(píng)分和躁動(dòng)評(píng)分均低于B組（P＜0.05），兩組患兒圍術(shù)期均未出現(xiàn)低血壓和心動(dòng)過緩。 結(jié)論 　右美托咪定用于小兒七氟烷吸入麻醉能夠增強(qiáng)術(shù)后鎮(zhèn)痛，減少蘇醒期躁動(dòng)。

引用本文： 趙艷玲,王光磊. 右美托咪定對(duì)小兒七氟烷吸入麻醉蘇醒期躁動(dòng)的影響. 華西醫(yī)學(xué), 2012, 27(9): 1366-1368. doi: 復(fù)制

1. 　Sikich N, Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale[J]. Anesthesiology, 2004, 100(5): 1138-1145.
2. 　Cole JW, Murray DJ, Mcallister JD, et al. Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia[J]. Paediatr Anaesth, 2002, 12(5): 442-447.
3. 　Weldon BC, Bell M, Craddock T. The effect of caudal analgesia on emergence agitation in children after sevoflurane versus halothane anesthesia[J]. Anesth Analg, 2004, 98(2): 321-326.
4. 　郭繼龍, 張聯(lián)義, 王光磊, 等. 腹股溝斜疝修補(bǔ)術(shù)的臨床觀察[J]. 徐州醫(yī)學(xué)院學(xué)報(bào), 2008, 28(1): 746-748.
5. 　Veyckemans F. Excitation phenomena during sevoflurane anaesthesia in children[J]. Curr Opin Anaesthesiol, 2001, 14(3): 339-343.
6. 　Okamoto T, Mori T, Takeda T, et al. Dexmedetomidine is an excellent sedative for voice monitoring surgery[J]. Masui, 2012, 61(5): 542-554.
7. 　Bajwa SJ, Kaur J, Singh A, et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine[J]. Indian J Anaesth, 2012, 56(2): 123-128.
8. 　Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials[J]. Anesthesiology, 2012, 116(6): 1312-1322.
9. 　Santos LC, Ludders JW, Erb HN, et al. A randomized, blinded, controlled trial of the antiemetic effect of ondansetron on dexmedetomidine-induced emesis in cats[J]. Vet Anaesth Analg, 2011, 38(4): 320-327.
10. 　Massad IM, Mohsen WA, Basha AS, et al. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery[J]. Saudi Med J, 2009, 30(12): 1537-1541.
11. 　Mizrak A, Erbagci I, Arici T, et al. Dexmedetomidine use during strabismus surgery in agitated children[J]. Med Princ Pract, 2011, 20(5): 427-432.
12. 　Ozcengiz D, Gunes Y, Melatonin O. Dexmedetomidine and midazolam for prevention of postoperative agitation in children[J]. J Anesth, 2011, 25(2): 184-188.
13. 　Isik B, Arslan M, Tunga AD, et al. Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery[J]. Paediatr Anaesth, 2006, 16(7): 748-753.
14. 　Saadawy I, Boker A, Elshahawy MA, et al. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics[J]. Acta Anaesthesiol Scand, 2009, 53(2): 251-256.
  1. 1. 　Sikich N, Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale[J]. Anesthesiology, 2004, 100(5): 1138-1145.
  2. 2. 　Cole JW, Murray DJ, Mcallister JD, et al. Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia[J]. Paediatr Anaesth, 2002, 12(5): 442-447.
  3. 3. 　Weldon BC, Bell M, Craddock T. The effect of caudal analgesia on emergence agitation in children after sevoflurane versus halothane anesthesia[J]. Anesth Analg, 2004, 98(2): 321-326.
  4. 4. 　郭繼龍, 張聯(lián)義, 王光磊, 等. 腹股溝斜疝修補(bǔ)術(shù)的臨床觀察[J]. 徐州醫(yī)學(xué)院學(xué)報(bào), 2008, 28(1): 746-748.
  5. 5. 　Veyckemans F. Excitation phenomena during sevoflurane anaesthesia in children[J]. Curr Opin Anaesthesiol, 2001, 14(3): 339-343.
  6. 6. 　Okamoto T, Mori T, Takeda T, et al. Dexmedetomidine is an excellent sedative for voice monitoring surgery[J]. Masui, 2012, 61(5): 542-554.
  7. 7. 　Bajwa SJ, Kaur J, Singh A, et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine[J]. Indian J Anaesth, 2012, 56(2): 123-128.
  8. 8. 　Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials[J]. Anesthesiology, 2012, 116(6): 1312-1322.
  9. 9. 　Santos LC, Ludders JW, Erb HN, et al. A randomized, blinded, controlled trial of the antiemetic effect of ondansetron on dexmedetomidine-induced emesis in cats[J]. Vet Anaesth Analg, 2011, 38(4): 320-327.
  10. 10. 　Massad IM, Mohsen WA, Basha AS, et al. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery[J]. Saudi Med J, 2009, 30(12): 1537-1541.
  11. 11. 　Mizrak A, Erbagci I, Arici T, et al. Dexmedetomidine use during strabismus surgery in agitated children[J]. Med Princ Pract, 2011, 20(5): 427-432.
  12. 12. 　Ozcengiz D, Gunes Y, Melatonin O. Dexmedetomidine and midazolam for prevention of postoperative agitation in children[J]. J Anesth, 2011, 25(2): 184-188.
  13. 13. 　Isik B, Arslan M, Tunga AD, et al. Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery[J]. Paediatr Anaesth, 2006, 16(7): 748-753.
  14. 14. 　Saadawy I, Boker A, Elshahawy MA, et al. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics[J]. Acta Anaesthesiol Scand, 2009, 53(2): 251-256.