| 摘要: |
| [摘要]目的：比较右美托咪定单独或分别复合咪达唑仑、氯胺酮作为儿童术前用药的镇静效果及安全性。方法：选择美国麻醉医师协会（ASA）Ⅰ~Ⅱ级行择期手术患儿75例，年龄2~12岁，随机分为右美托咪啶组（D组）、右美托咪定复合咪达唑仑组（DM组）和右美托咪定复合氯胺酮组（DK组）。术前30 min右美托咪啶1 μg/kg、右美托咪啶1 μg/kg+咪达唑仑0.2 mg/kg和右美托咪定1 μg/kg+氯胺酮3 mg/kg分别滴鼻给药，观察给药后5 min（T1）、10 min（T2）、15 min（T3）、20 min（T4）、25 min（T5）、30 min（T6）时患儿的心率（HR）、收缩压（SBP）、舒张压（DBP）、呼吸频率（RR）、氧饱和度（SpO2）和Ramsay镇静评分。结果：与D组比较，DK和DM组T1~T6时心率降低（P<0.05）；与D组、DK组比较，DM组T1~T6时收缩压降低（P<0.05）；与D组、DK组比较，DM组T1~T6时舒张压降低（P<0.05）。与D组比较，DK组和DM组T1~T6时镇静评分升高（P<0.05）；与DM组比较，DK组T2~T6时镇静评分降低（P<0.05），无镇静过度。结论：在小儿麻醉前给予右美托咪定 1 μg/kg +氯胺酮3 mg/kg滴鼻可以产生良好的镇静效果且无滴鼻刺激性。 |
| 关键词: 右美托咪定 滴鼻 咪达唑仑 氯胺酮 术前镇静 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2019.02.006 |
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| 基金项目:四川省卫生计生委2015年科研课题，编号150043；成都市卫计委卫生计生委2015年科研课题，编号2015100。 |
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| A Comparative Study of Dexmedetomidine Respectively Combined with Ketamine and Midazolam for Preoperative Sedation in Children |
| Hu Xiaojuan, Li Jie, Wu Liguo, Kang Ling, Wang Fei |
| (Sichuan Provincial People’s Hospital Wenjiang Hospital, Wenjiang District People 's Hospital of Chengdu, Sichuan Chengdu 611130, China) |
| Abstract: |
| [Abstract] Objective: To compare the preoperative sedative effects and safety of dexmedetomidine respectively combined with ketamine and midazolam for preoperative sedation in children. Methods: Seventy-five children aged 2-12 years undergoing elective surgery from the American Society of Anesthesiologists (ASA) I~II were randomly divided into the dexmedetomidine group (group D), dexmedetomidine combined with midazolam group (group DM) and dexmedetomidine combined with ketamine group (group DK). Dexmedetomidine 1 g/kg, dexmedetomidine 1 g/kg+midazolam 0.2 mg/kg and dexmedetomidine 1 g/kg+ketamine 3 mg/kg were given by intranasal administration respectively 30 min before surgery. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), oxygen saturation (SpO2) and Ramsay sedation score were observed before administration (T0) and after administration of 5 min (T1), 10 min (T2), 15 min (T3), 20 min (T4), 25 min (T5) and 30 min (T6). Results: Compared with group D, the HR decreased in group DK and group DM at T1-T6 (P<0.05). Compared with group D and group DK, the SBP decreased in group DM at T1-T6 (P<0.05). Compared with group D and group DK, the DBP decreased in group DM at T1-T6 (P<0.05). Compared with group D, the sedation score increased in group DK and group DM at T1-T6 (P<0.05). Compared with group DM, the sedation score decreased in group DK at T2-T6 (P<0.05), and there was no excessive sedative effects. Conclusion: Dexmedetomidine 1 μg/kg+ketamine 3 mg/kg in intranasal administration before pediatric anesthesia produces a good sedative effect without any nasal irritation. |
| Key words: dextrotomidine intranasal administration midazolam ketamine preoperative sedation |
