河北医学2017，Vol.23Issue(11)：1828-1833,6.DOI:10.3969/j.issn.1006-6233.2017.11.019
右美托咪定非静脉给药途径在儿科下腹手术术后镇痛的应用
Application of Dexmedetomidine with Non-intravenous Route in Postoperative Analgesia in Pediatric Patients Undergoing Abdominal Surgery
摘要
Abstract
Objective:To investigate the effect of dexmedetomidine intravenous administration on post-operative analgesia in pediatric patients undergoing abdominal surgery. Methods:60 patients who were under-going the general anesthesia for lower abdomen surgery were randomly devided into there groups, each group 20 cases. Patients in group B were received dexmedetomidine 1ug/kg nasal drops before operation 30min;Pa-tients in group A, C were received volume normal saline nasal drops. The three groups were given atropine 0. 01-0.02mg/kg, lidocaine 1mg/kg, propofol 2mg/kg, sevoflurane 6-8%, oxygen flow 2L/min, waiting for the eyelash reflex disappeared, placed the laryngeal mask, sevoflurane dropped to 1-2%. In group A and group B, 0.25% ropivacaine 1ml/kg was injected after the success of sacral block, group C was given 0.25%ropivacaine 1ml/kg+dexmedetomidine 1ug/kg, sacral block was given total amount of 20ml cap. 1. Each pa-tient general information respectively were record;2. The time of operation, induction, extubation and anes-thesia awake were recorded;3. The adverse events such as bradycardia, delayed awakening, laryngismus, u-rine retention were and awakening period agitation score were recorded. 4. Postoperative 4, 8, 12, 16, 20, 24 hours analgesic score, sedation score and analgesia time were recorded. Results:1. The general situation have no statistical significance ( P>0.05);2. The time of operation, extubation and anesthesia awake have no sta-tistical significance ( P>0.05) , the induction time of B group are shorter than A and C groups ( P<0.05);3. All the three groups have no hypoxemia, delayed awakening and urine retentionwere;Compared with group B and C, the emergence laryngismus and awakening period agitation score were higher in group A ( P<0.05);the analgesia time were shorter, group C was the longest. 4. All the analgesic score of the three groups were less than 4 points, sedation score for 2-3 minute in postoperative 4 h. Compared with group A, analgesic and sedation score of the group B and C are lower in postoperative 8 h( P<0.05) . Compared with group A and B, analgesic and sedation score of the group C were lower in postoperative 12, 16, 20h ( P<0.05) . There was no statistical significance in postoperative 24h ( P>0.05) . Conclusion: Intranasal dexmedetomidine ( DEX) ap-plication used in pediatric anesthesia induction period undergoing the lower abdomen and lower extremity sur-gery could significantly reduce induction time and have early postoperative analgesia sedation. For caudal block, which received the ropivacaine mixed with 1ug/kg dexmedetomidine can prolonge analgesia calm times and reduce adverse reaction during anesthesia recovery period .关键词
右美托咪啶/滴鼻/骶管阻滞/儿科/术后镇痛Key words
Dexmedetomidine/Intranasal/Sacral canal blocking/Pediatric/Postoperative analgesia引用本文复制引用
曹雪峰,赵亮,刘旭东,姜亚男,刘玉伶,李艳..右美托咪定非静脉给药途径在儿科下腹手术术后镇痛的应用[J].河北医学,2017,23(11):1828-1833,6.基金项目
2015年承德市科学技术研究与发展计划项目,(编号:20157057) （编号:20157057）
