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右美托咪定麻醉对视网膜母细胞瘤切除术患儿呼吸功能的影响。

Effect of dexmedetomidine anesthesia on respiratory function in pediatric patients undergoing retinoblastoma resection.

作者信息

Rong Xi, Sun Chunlei, Zhang Feng, Zheng Jie

机构信息

School of Pharmacy of Qingdao University, Qingdao, Shandong 266021, P.R. China.

Department of Pharmacy, Yidu Central Hospital of Weifang, Weifang, Shandong 262500, P.R. China.

出版信息

Oncol Lett. 2019 Mar;17(3):2721-2728. doi: 10.3892/ol.2019.9893. Epub 2019 Jan 4.

Abstract

The aim of this study was to investigate the effect of dexmedetomidine (Dex) on the respiratory function during anesthesia induction in pediatric patients undergoing retinoblastoma (RB) resection. A total of 87 pediatric patients who underwent RB resection in Yidu Central Hospital of Weifang were recruited into this study. General anesthesia was first induced for all patients, of which 45 were randomly assigned to the experimental group and received Dex through an intravenous infusion pump to maintain general anesthesia. The remaining 42 patients were assigned to the control group and received saline through an intravenous infusion pump. Respiratory function and hemodynamic indexes at five time-points, i.e., before anesthesia induction (T0), 5 min after injection of anesthetic agents (T1), before intubation (T2), 15 min after intubation (T3), and 30 min after extubation (T4), were recorded and compared. Incidence of perioperative cardiac and respiratory adverse events was counted in both groups, and post-anesthesia resuscitation was evaluated and compared. Compared with T0, the respiratory rate (R) of the experimental group was lower at T1-T4, but there was no statistical difference (P<0.05). Compared with T0, the control group had a higher R at T2, lower R at T3 and T4 (P<0.05), and there was no significant difference in R between T0 and T1 (P>0.05). At the same time-point, compared with the experimental group, the R was higher at T2, and lower at T3 and T4 in the control group (P<0.05), and no significant difference was found at T1. Blood oxygen saturation (SpO) of the experimental group was slightly lower than that of T0 at T1-T4 (P>0.05). In the control group, the levels of SpO were significantly lower at T1-T4 than those at T0 (P<0.05). Compared with the experimental group at the same time-point, SpO of the control group at T1-T4 decreased significantly (P<0.05). The heart rate (HR) of the experimental and control groups was lower at T1-T4 than that at T0 (P<0.05). The HR of the experimental group was higher than that of the control group at T1-T4 (P<0.05). Mean arterial pressure (MAP) of the experimental and control groups was lower at T1-T4 than that at T0 (P<0.05). MAP of the control group was higher than that of the experimental group at T2 but lower than that at T0 of the control group. MAP of the control group was lower than that of the experimental group at T1-T4. There was no significant difference in incidence of tachycardia, bradycardia, vomiting, hypoxia and laryngism between the two groups (P>0.05). There was no difference in resuscitation and extubation time between the two groups (P>0.05). Finally, agitation of the control group was more severe than that of the experimental group (P<0.05). Therefore, Dex can improve the respiratory function and hemodynamic stability during anesthesia induction in children with RB resection.

摘要

本研究旨在探讨右美托咪定(Dex)对视网膜母细胞瘤(RB)切除术小儿患者麻醉诱导期间呼吸功能的影响。选取在潍坊益都中心医院接受RB切除术的87例小儿患者纳入本研究。首先对所有患者实施全身麻醉,其中45例随机分配至试验组,通过静脉输液泵输注Dex以维持全身麻醉。其余42例患者分配至对照组,通过静脉输液泵输注生理盐水。记录并比较麻醉诱导前(T0)、注射麻醉剂后5分钟(T1)、插管前(T2)、插管后15分钟(T3)及拔管后30分钟(T4)这五个时间点的呼吸功能及血流动力学指标。统计两组围手术期心脏及呼吸不良事件的发生率,并对麻醉后复苏情况进行评估和比较。与T0相比,试验组在T1 - T4时呼吸频率(R)降低,但差异无统计学意义(P<0.05)。与T0相比,对照组在T2时R升高,在T3和T4时R降低(P<0.05),T0与T1时R差异无统计学意义(P>0.05)。在同一时间点,与试验组相比,对照组在T2时R较高,在T3和T4时R较低(P<0.05),T1时差异无统计学意义。试验组在T1 - T4时血氧饱和度(SpO)略低于T0(P>0.05)。对照组在T1 - T4时SpO水平显著低于T0(P<0.05)。与试验组在同一时间点相比,对照组在T1 - T4时SpO显著降低(P<0.05)。试验组和对照组在T1 - T4时心率(HR)均低于T0(P<0.05)。试验组在T1 - T4时HR高于对照组(P<0.05)。试验组和对照组在T1 - T4时平均动脉压(MAP)均低于T0(P<0.05)。对照组在T2时MAP高于试验组,但低于对照组自身T0时的MAP。对照组在T1 - T4时MAP低于试验组。两组心动过速、心动过缓、呕吐、缺氧及喉痉挛的发生率差异无统计学意义(P>0.05)。两组复苏及拔管时间差异无统计学意义(P>0.05)。最后,对照组的躁动比试验组更严重(P<0.05)。因此,Dex可改善RB切除术小儿患者麻醉诱导期间的呼吸功能及血流动力学稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f082/6365899/b5f9caff6213/ol-17-03-2721-g00.jpg

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