Zhou Mi, Wang Qiang, Zhang Qiong, Liu Yifei, Zhan Leyun, Shu Aihua
Department of Anesthesiology, The People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei 443000, P.R. China.
Exp Ther Med. 2018 Mar;15(3):2973-2977. doi: 10.3892/etm.2018.5737. Epub 2018 Jan 11.
This study observed the clinical efficacy of pre-injection of dexmedetomidine of different doses before surgery and the adverse reactions during the recovery period in pediatric intravenous general anesthesia without tracheal intubation. Pediatric patients who received general anesthesia without tracheal intubation before surgery from January 2016 to March 2017 were randomly divided into four groups (n=30), and were respectively treated with intravenous pump infusion of loaded dexmedetomidine of high-dose (2.5 µg/kg), middle-dose (1.5 µg/kg) and low-dose (0.5 µg/kg), while the children in the control group received injection of normal saline in same dose. Then, the mean arterial pressure (MAP) at different time points (5 and 10 min after administration, after anesthesia and after surgery), heart rate, Ramsay sedation score changes and adverse reactions during recovery period of anesthesia of pediatric patients were compared among four groups. At 5 and 10 min after administration, Ramsay scores of high-dose group and middle-dose group were higher than that of the control group, and the differences had statistical significance (P<0.05). There was no significant difference in comparison of Ramsay scores between low-dose group and the control group. The MAP and heart rate after anesthesia and after surgery of pediatric patients with pump infusion of dexmedetomidine in the three groups were decreased significantly compared to those of the control group, and the differences had statistical significance (P<0.05). The incidence rate of adverse reaction of pediatric patients during the recovery period after pump infusion in the three groups and the control group was, respectively, 13/30, 8/30, 7/30 and 8/30, and the differences were statistically significant (P<0.05). The sedative effect and safety of pre-injection of dexmedetomidine in pediatric intravenous general anesthesia without tracheal intubation are promising, and the medium dosage can maximize the anesthetic effect with less side effects.
本研究观察了不同剂量右美托咪定术前预注在小儿非气管插管静脉全身麻醉中的临床疗效及恢复期不良反应。选取2016年1月至2017年3月术前接受非气管插管全身麻醉的小儿患者，随机分为四组（n = 30），分别给予静脉泵注高剂量（2.5μg/kg）、中剂量（1.5μg/kg）和低剂量（0.5μg/kg）负荷量右美托咪定，对照组小儿给予相同剂量的生理盐水注射。然后，比较四组小儿患者在不同时间点（给药后5、10分钟，麻醉后及术后）的平均动脉压（MAP）、心率、Ramsay镇静评分变化及麻醉恢复期不良反应。给药后5、10分钟，高剂量组和中剂量组的Ramsay评分高于对照组，差异有统计学意义（P < 0.05）。低剂量组与对照组Ramsay评分比较差异无统计学意义。三组泵注右美托咪定的小儿患者麻醉后及术后的MAP和心率较对照组均显著降低，差异有统计学意义（P < 0.05）。三组及对照组泵注后小儿患者恢复期不良反应发生率分别为13/30、8/30、7/30和8/30，差异有统计学意义（P < 0.05）。右美托咪定术前预注在小儿非气管插管静脉全身麻醉中的镇静效果及安全性良好，中等剂量可在减少副作用的同时最大化麻醉效果。
