Dilek Ozcengiz, Yasemin Günes, Atci Mustafa
Çukurova University Faculty of Medicine Department of Anaesthesiology, Adana/Turkey.
J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):17-22.
In paediatric patients dexmedetomidine has been reported to be effective in various clinical settings including provision of sedation during mechanical ventilation, prevention of emergence delirium after general anaesthesia, sedation during non invasive radiological procedures. However very few data of its use in newborn is available. PATIENTS #ENTITYSTARTX00026;
Sixteen new born patients of age 2-28 days were studied. Anaesthesia was induced with 1 mgkg(-1) ketamine intravenously. Dexmedetomicline 1 μgkg(-1) was infused within ten minutres. Maintenance infusion was started as 0.5-0.8 μg kg(-1)h(-1) until the end of surgery ortrcheel intubation was done all patients were mechanical ventelated with O(2)+H(2)O safberane 0.1-0.2%. Non invasive systolic & chastake blood pressure, heart rate, SPO(2), DETCO(2), inhated & end trial sevophrame conc and body temperature were monitored.
No significant difference was observed in the measured values of haemodynamic parameter at different intervals and the base line values. No patient had hypotension bradycardia hypertension hypoxia or respiratory depression. Patients had mild hypothermia during post-operative period.
Dexmedetomidine 1 μgkg(-1) followed by maintenance dose of 0.5 μg kg(-1)h(-1) as an adjacent to sevoflurane anaesthesia in new born undergoing laparatomy provides haemodynamic stability during heightened surgical stimulate.
据报道，右美托咪定在儿科患者的各种临床环境中均有效，包括机械通气期间的镇静、全身麻醉后预防苏醒期谵妄、非侵入性放射检查期间的镇静。然而，关于其在新生儿中使用的数据非常少。
研究了16例年龄在2至28天的新生儿患者。静脉注射1mg/kg氯胺酮诱导麻醉。在10分钟内输注1μg/kg右美托咪定。开始维持输注，速率为0.5 - 0.8μg/（kg·h），直到手术结束或进行气管插管。所有患者均使用0.1 - 0.2%的氧气+七氟醚进行机械通气。监测无创收缩压和舒张压、心率、血氧饱和度（SPO₂）、呼气末二氧化碳分压（DETCO₂）、吸入和呼出的七氟醚浓度以及体温。
在不同时间间隔测量的血流动力学参数值与基线值之间未观察到显著差异。没有患者出现低血压、心动过缓、高血压、低氧血症或呼吸抑制。患者在术后出现轻度体温过低。
在接受剖腹手术的新生儿中，右美托咪定1μg/kg随后以0.5μg/（kg·h）的维持剂量与七氟醚麻醉联合使用，在手术刺激增强期间可提供血流动力学稳定性。
