| 摘要: |
| 目的:探讨右美托咪定联合艾司氯胺酮是否能够安全用于儿童纤维支气管镜(纤支镜)的检查;如果加用舒芬太尼,是否
能够减少艾司氯胺酮的用量,降低不良反应发生率。方法:选取我院拟择期行纤支镜检查的患儿40 例,按随机数表法分为E 组
和S 组各20 例。E 组采用“右美托咪定1 μg/ kg+艾司氯胺酮1 mg/ kg”麻醉方案,S 组采用“右美托咪定1 μg/ kg+艾司氯胺酮
1 mg/ kg+舒芬太尼0. 1 μg/ kg”麻醉方案。比较两组患儿基础(T0 )、诱导后(T1 )、纤支镜通过声门(T2 )、纤支镜通过隆突(T3 )、
检查完成10 min(T4 )5 个时间点的心率(HR)、平均动脉压( MAP)、血氧饱和度( SpO2 ) 水平和不良反应。结果:E 组T2 、T3 的
HR 水平高于T1(P 均<0. 05),T0 ~T4 的MAP、SpO2 水平变化差异均无统计学意义(P 均>0. 05)。S 组T0 ~T4 的HR、MAP、SpO2
水平变化差异均无统计学意义(P 均>0. 05)。两组患儿T0 ~T4 的MAP、SpO2 水平变化差异均无统计学意义(P 均>0. 05)。两
组低氧血症发生率、艾司氯胺酮等药物用量比较差异均无统计学意义(P 均>0. 05)。结论:右美托咪定联合艾司氯胺酮能够安
全用于儿童纤支镜的检查,加用舒芬太尼既不能减少艾司氯胺酮等药物的用量,也不能降低低氧血症等不良反应的发生率,所
以没有必要。 |
| 关键词: 右美托咪定 艾司氯胺酮 小儿 纤维支气管镜 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2023.03.009 |
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| 基金项目: |
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| The Safety of Esketamine Combined with Dexmedetomidine for Pediatric Painless Fiberoptic Bronchoscopy |
| Ji Yingying, Jiang Jing, Hou Huiyan, Dan Yingzhi |
| (Shanghai Children’ s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China) |
| Abstract: |
| Objective: To explore the safety of painless anesthesia of dexmedetomidine combined with esketamine during fiberoptic
bronchoscopy in children. If sufentanil is added, whether it can reduce the dosage of esketamine and reduce the incidence of adverse reactions. Methods: A total of 40 children who were scheduled to undergo fiberoptic bronchoscopy in our hospital were randomized into
2 groups in average, dexmedetomidine 1 μg/ kg + esketamine 1 mg/ kg (group E) and dexmedetomidine 1 μg/ kg + esketamine 1 mg/ kg +
sufentanil 0. 1 μg/ kg (group S). The vital signs including heart rate (HR), mean arterial pressure (MAP), pulse oxyhemoglobin
saturation (SpO2 ) and adverse reactions at basic (T0 ), after induction (T1 ), the fiberoptic bronchoscopy passing through the glottis
(T2 ), the scope passing through the carina (T3 ), and 10 min after completion (T4 ) were observed and compared between the two
groups. Results: The HR of T2 and T3 in the group E was significantly faster than that of T1 (all P<0. 05), and there was no significant
difference in MAP and SpO2 at T0 to T4 (all P>0. 05). There was no significant difference in HR, MAP and SpO2 at T0 to T4 between the
two groups (all P>0. 05). There was no significant difference in the incidence of hyoxemia and drug dosage of esketamine between the
two groups (all P>0. 05). Conclusion: Dexmedetomidine combined with esketamine can be used for pediatric fiberoptic bronchoscopy,
but the additional use of sufentanil can not reduce the dosage of esketamine, nor the incidence of adverse reactions like hyoxemia. Thus,
it’s no need of adding sufentanil. |
| Key words: dexmedetomidine esketamine pediatric fiberoptic bronchoscopy |
