The Effect of Dexmedetomidine on the Agitation Induced by Sevoflurane during the Recovery Period of General Anesthesia in Children_West China Medical Journal

Authors：

ZHAO Yanling ¹ , WANG Guanglei ²

1. Department of Anesthesiology, Tongshan Daxu Town Center Hospital, Xuzhou, Jiangsu 221124, P. R. China; 2. Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002, P. R. China;

Corresponding author：

Keywords：

右美托咪定; 七氟烷; 麻醉，吸入; 躁动

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目的　探讨右美托咪定对小儿七氟烷吸入麻醉苏醒期躁动的影响。方法　选择2011年3月－2012年1月美国麻醉医师协会分级Ⅰ～Ⅱ级、年龄2～8岁、择期行疝囊高位结扎术和隐睾下降固定术患儿40例，随机分为2组，右美托咪定组（A组）和对照组（B组），两组患儿在年龄、体重、手术种类无明显差异。两组患儿均采用面罩8%七氟烷吸入麻醉诱导，开放静脉，给予盐酸戊乙奎醚0.1 mg/kg、顺式阿曲库铵0.15 mg/kg，插入喉罩，麻醉维持根据血压、心率及脑电双频指数调节吸入麻醉药浓度。A组静脉给予1 μg/kg右美托咪定，B组给予同等容量的生理盐水。入室至手术结束时连续观察收缩压、舒张压、心率、血氧饱和度，记录清醒时间、拔除喉罩时间，记录苏醒期并发症的发生数。记录入麻醉恢复室即刻（0 min）、15、30、60、90 min患儿疼痛和躁动评分。结果　两组患儿在手术时间、清醒时间以及拔除喉罩时间差异无统计学意义（P＞0.05），A组术后入恢复室0、15、30 min疼痛评分和躁动评分均低于B组（P＜0.05），两组患儿围术期均未出现低血压和心动过缓。结论　右美托咪定用于小儿七氟烷吸入麻醉能够增强术后镇痛，减少苏醒期躁动。

Citation： ZHAO Yanling,WANG Guanglei. The Effect of Dexmedetomidine on the Agitation Induced by Sevoflurane during the Recovery Period of General Anesthesia in Children. West China Medical Journal, 2012, 27(9): 1366-1368. doi: Copy

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13.	Isik B, Arslan M, Tunga AD, et al. Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery[J]. Paediatr Anaesth, 2006, 16(7): 748-753.
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1. 　Sikich N, Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale[J]. Anesthesiology, 2004, 100(5): 1138-1145.
2. 　Cole JW, Murray DJ, Mcallister JD, et al. Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia[J]. Paediatr Anaesth, 2002, 12(5): 442-447.
3. 　Weldon BC, Bell M, Craddock T. The effect of caudal analgesia on emergence agitation in children after sevoflurane versus halothane anesthesia[J]. Anesth Analg, 2004, 98(2): 321-326.
4. 　郭继龙, 张联义, 王光磊, 等. 腹股沟斜疝修补术的临床观察[J]. 徐州医学院学报, 2008, 28(1): 746-748.
5. 　Veyckemans F. Excitation phenomena during sevoflurane anaesthesia in children[J]. Curr Opin Anaesthesiol, 2001, 14(3): 339-343.
6. 　Okamoto T, Mori T, Takeda T, et al. Dexmedetomidine is an excellent sedative for voice monitoring surgery[J]. Masui, 2012, 61(5): 542-554.
7. 　Bajwa SJ, Kaur J, Singh A, et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine[J]. Indian J Anaesth, 2012, 56(2): 123-128.
8. 　Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials[J]. Anesthesiology, 2012, 116(6): 1312-1322.
9. 　Santos LC, Ludders JW, Erb HN, et al. A randomized, blinded, controlled trial of the antiemetic effect of ondansetron on dexmedetomidine-induced emesis in cats[J]. Vet Anaesth Analg, 2011, 38(4): 320-327.
10. 　Massad IM, Mohsen WA, Basha AS, et al. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery[J]. Saudi Med J, 2009, 30(12): 1537-1541.
11. 　Mizrak A, Erbagci I, Arici T, et al. Dexmedetomidine use during strabismus surgery in agitated children[J]. Med Princ Pract, 2011, 20(5): 427-432.
12. 　Ozcengiz D, Gunes Y, Melatonin O. Dexmedetomidine and midazolam for prevention of postoperative agitation in children[J]. J Anesth, 2011, 25(2): 184-188.
13. 　Isik B, Arslan M, Tunga AD, et al. Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery[J]. Paediatr Anaesth, 2006, 16(7): 748-753.
14. 　Saadawy I, Boker A, Elshahawy MA, et al. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics[J]. Acta Anaesthesiol Scand, 2009, 53(2): 251-256.

West China Medical Journal

The Effect of Dexmedetomidine on the Agitation Induced by Sevoflurane during the Recovery Period of General Anesthesia in Children

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