| 摘要: |
| 目的:探讨不同剂量右美托咪定对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)腭咽成形术患儿苏醒期躁动及血流动力
学的影响。方法:选取2019 年1 月至2021 年8 月接受腭咽成形术治疗的100 例OSAHS 患儿,采用随机数表法分为A 组(33 例)、
B 组(33 例)和C 组(34 例)。三组患儿均采用全身麻醉,于麻醉诱导前,A 组给予0. 2 μg/ kg 右美托咪定,B 组给予0. 4 μg/ kg
右美托咪定,C 组给予0. 6 μg/ kg 右美托咪定。采用广义估计方程分析两组患儿入室时( T0 )、泵注10 min 时( T1 )、拔管时
(T2 )、苏醒时(T3 )的血流动力学[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2 )]相关指标,比较三组患儿苏醒期相关情
况。结果:基于广义估计方程分析,结果显示,T1 时三组患儿HR 水平均较T0 时升高,但在T2 时回降,且趋于平稳,但三组患儿
各时点之间比较差异无统计学意义(P>0. 05);三组患儿MAP、SpO2 水平先降后升,但三组患儿各时点之间比较差异无统计学
意义(P>0. 05);C 组的苏醒时间和拔管时间均长于A 组和B 组,B 组、C 组的儿童麻醉苏醒期躁动量表评分均低于A 组( P<
0. 01),但A 组和B 组的苏醒时间和拔管时间比较、B 组和C 组的PAED 评分比较,差异无统计学意义(P>0. 05)。结论:不同剂
量的右美托咪定均可维持OSAHS 腭咽成形术患儿的血流动力学稳定,无剂量相关性,但0. 4 μg/ kg 右美托咪定可有效降低患
儿术后躁动发生风险,且患儿呼吸和意识恢复更快。 |
| 关键词: 阻塞性睡眠呼吸暂停低通气综合征 腭咽成形术 右美托咪定 血流动力学 苏醒期躁动 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2023.02.013 |
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| 基金项目: |
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| Comparison on Effects of Different Doses of Dexmedetomidine on Emergency Agitation and Hemodynamicsin Children with OSAHS after Palatopharyngoplasty |
| Kong Jianqiang, Wang Qiong, Wang Jiansheng |
| ((Shanghai Baoshan Hospital of Integrated Traditional Chinese Medicine and
Western Medicine, Shanghai 201999, China)) |
| Abstract: |
| Objective: To investigate the effects of different doses of dexmedetomidine on emergence agitation and hemodynamics in
children with obstructive sleep apnea-hypopnea syndrome (OSAHS) after palatopharyngoplasty. Methods: A total of 100 children with
OSAHS who underwent palatopharyngoplasty in the hospital from January 2019 to August 2021 were selected. They were randomized into
group A (33 cases), group B (33 cases) and group C (34 cases). General anesthesia was used in all three groups of children. Before
anesthesia induction, group A was given 0. 2 μg/ kg dexmedetomidine, group B was given 0. 4 μg/ kg dexmedetomidine, and group C
was given 0. 6 μg/ kg dexmedetomidine. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2 ) at
the time of entering the room (T0 ), 10 minutes of pumping (T1 ), extubating (T2 ) and recovery (T3 ) between the two groups were
analyzed by generalized estimation equation, and the correlation among the three groups during the recovery period was compared.
Results: Based on the analysis of generalized estimation equation, the results showed that, at T1 , the HR levels of the three groups
increased than those at T0 , but decreased back at T2 and tended to be stable, without statistically significant difference in terms of
comparison among the three groups at each time point (P>0. 05); the levels of MAP and SpO2 in the three groups decreased at first and
then increased, without significant difference (P>0. 05); the recovery time and extubating time of group C were longer than those of
group A and group B, and the Pediatric Anesthesia Emergence Delirium Scale (PAED) scores of group B and group C were lower than
those of group A (P<0. 01), but there was no statistically significant difference in the comparison of the recovery time and extubating
time between group A and group B, either in the comparison of PAED scores between group B and group C (P>0. 05). Conclusion:
Different doses of dexmedetomidine can maintain hemodynamic stability in children with OSAHS after palatopharyngoplasty without dose
correlation. However, 0. 4 μg/ kg dexmedetomidine can effectively reduce the risk of postoperative agitation, and lead to faster recovery
of children’s breathing and consciousness. |
| Key words: obstructive sleep apnea-hypopnea syndrome palatopharyngoplasty dexmedetomidine hemodynamics emergence agitation |
