Department of Anesthesiology, The First People's Hospital of Wenling, Taizhou, Zhejiang Province, China.
Medicine (Baltimore). 2022 Dec 30;101(52):e32388. doi: 10.1097/MD.0000000000032388.
To investigate the effect of dexmedetomidine (DEX) on hemodynamics and recovery period after femoral shaft fracture surgery. Fifty-two patients, aged 3 to 7 years, who underwent femoral shaft fracture reduction surgery in our hospital in 2019 were randomly divided into the experimental group (n = 26) and the control group (n = 26). Both groups were given routine propofol combined with remifentanil by intravenous anesthesia. The experimental group was continuously pumped with DEX after induction of anesthesia, while the control group was continuously pumped with the same volume of normal saline. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0), when laryngeal mask was inserted (T1), when skin was cut (T2), when intramedullary needle was inserted (T3), and when laryngeal mask was removed (T4). Extubation time after anesthesia withdrawal was recorded in the 2 groups. According to the Pediatric Anesthesia Emergence Delirium score, the agitation and the incidence of agitation were recorded immediately after extubation (T5), 10 minutes after entering the recovery room (T6) and 30 minutes after entering the recovery room (T7). There was no significant difference in MAP and HR between the 2 groups at T0 and T1 time points (P > .05). The MAP and HR of the experimental group at T2 to T4 were significantly lower than those of the control group (P < .05). The extubation time of the experimental group was longer than that of the control group (P < .05), but the Pediatric Anesthesia Emergence Delirium score and the incidence of agitation in the recovery period of the experimental group were lower than those of the control group (P < .05). In femoral shaft fracture surgery, intravenous anesthesia combined with continuous pumping DEX can effectively stabilize the hemodynamics of patients, and the incidence of postoperative agitation during anesthesia recovery is low.
观察右美托咪定(DEX)对小儿股骨干骨折手术患者血流动力学及苏醒期的影响。方法:选取 2019 年我院收治的行股骨干骨折切开复位内固定术的患儿 52 例,年龄 37 岁,采用随机数字表法分为观察组(n=26)和对照组(n=26)。两组均采用异丙酚复合瑞芬太尼静脉麻醉,观察组麻醉诱导后持续泵注 DEX,对照组持续泵注等容量生理盐水。记录两组麻醉诱导前(T0)、置入喉罩时(T1)、切皮时(T2)、置入髓内针时(T3)、拔除喉罩时(T4)的平均动脉压(MAP)和心率(HR),记录两组麻醉苏醒后拔除气管导管时间。采用小儿麻醉苏醒期躁动评分(PAED)记录两组患儿拔除气管导管后即刻(T5)、进入恢复室 10 min(T6)、进入恢复室 30 min(T7)时的躁动情况及发生率。结果:两组 T0、T1 时点 MAP、HR 比较差异无统计学意义(P>0.05),观察组 T2T4 时点 MAP、HR 均低于对照组(P<0.05);观察组患儿拔管时间长于对照组(P<0.05),但观察组患儿苏醒期 PAED 评分及躁动发生率均低于对照组(P<0.05)。结论:小儿股骨干骨折手术中,静脉麻醉复合持续泵注 DEX 能有效稳定患者血流动力学,降低麻醉恢复期术后躁动的发生率。