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右美托咪定在减少小儿心脏手术中芬太尼用量方面的临床疗效。

Clinical efficacy of dexmedetomidine in the diminution of fentanyl dosage in pediatric cardiac surgery.

作者信息

Sun Yingying, Ye Hongwu, Xia Yin, Li Yuanhai, Yuan Xianren, Wang Xing

机构信息

Department of Anesthesiology, AnHui Provincial Children's Hospital, Hefei, China.

Department of Anesthesiology, First Affiliated Hospital of AnHui Medical University, Hefei, China.

出版信息

Minerva Pediatr. 2017 Jun;69(3):181-187. doi: 10.23736/S0026-4946.16.04240-7. Epub 2015 Sep 1.

Abstract

BACKGROUND

This study aims to explore the clinical efficacy of dexmedetomidine (DEX) in the diminution of fentanyl dosage in pediatric cardiac surgery based on some clinical and biochemical parameters.

METHODS

Fifty pediatric patients (American Society of Anesthesiologists II), 1-6 years old, were randomly allocated into two groups: group F (control group), in which patients received normal saline and high dosage of fentanyl (30 μg/kg), and group D, in which patients were given DEX and low dosage of fentanyl (15 μg/kg). Some hemodynamic and clinical parameters of the two groups were recorded. Furthermore, stress hormone (serum cortisol, norepinephrine, blood glucose) levels and cytokine (interleukin 6, tumor necrosis factor alpha) levels in the two groups were compared with each other.

RESULTS

Stress hormone levels, cytokine levels, hemodynamic parameters and the consumption of sevoflurane did not differ between the two groups. Meanwhile, the extubation time was significantly shorter in Group D than F (P<0.05).

CONCLUSIONS

The results indicated that low dosage of fentanyl supplemented with DEX almost had the same anesthesia effects and inflammation extent compared with high dose of fentanyl, which suggested that infusion DEX might decrease fentanyl consumption in pediatric cardiac surgery.

摘要

背景

本研究旨在基于一些临床和生化参数,探讨右美托咪定(DEX)在小儿心脏手术中减少芬太尼用量的临床疗效。

方法

50例1 - 6岁的小儿患者(美国麻醉医师协会分级II级)被随机分为两组:F组(对照组),患者接受生理盐水和高剂量芬太尼(30μg/kg);D组,患者接受DEX和低剂量芬太尼(15μg/kg)。记录两组的一些血流动力学和临床参数。此外,比较两组的应激激素(血清皮质醇、去甲肾上腺素、血糖)水平和细胞因子(白细胞介素6、肿瘤坏死因子α)水平。

结果

两组的应激激素水平、细胞因子水平、血流动力学参数和七氟醚消耗量无差异。同时,D组的拔管时间明显短于F组(P<0.05)。

结论

结果表明,与高剂量芬太尼相比,低剂量芬太尼联合DEX几乎具有相同的麻醉效果和炎症程度,这表明输注DEX可能会减少小儿心脏手术中的芬太尼用量。

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