作　　者： (魏灵欣）; (邓晓明）; (王磊）; (隋静湖）; (郅娟）; (温超）; (徐瑾）; (刘具会）;

机构地区： 中国医学科学院,北京协和医学院,整形外科医院麻醉科,北京100144

出　　处： 《中国医学科学院学报》 2017年第4期465-470,共6页

摘　　要： 目的观察静脉注射右美托咪啶1μg/kg对小儿七氟烷吸入诱导无肌松气管插管的作用。方法选择4~10岁、美国麻醉医师协会分级为Ⅰ级、行择期整形外科手术的患者122例,按计算机随机抽样表格随机分为右美托咪定组和生理盐水对照组。患者入室后吸入8%七氟烷和50%氧化亚氮,待患者入睡建立静脉通路后,两组分别静脉注射右美托咪定(1μg/kg)和生理盐水。注射完毕1 min后开始气管插管。根据喉镜置入容易度、声带位置、咳嗽程度、下颌松弛度、体动程度对气管插管条件进行分级。观察记录气管插管成功率和满意气管插管成功率。结果右美托咪定组和生理盐水对照组气管插管成功率分别为97%和90%(P=0.143),满意气管插管率分别为82%和67%(P=0.04)。右美托咪定组插管前的平均动脉压和心率和插管后即刻的平均动脉压和心率比较差异均无统计学意义(P均>0.05)。结论静脉注射右美托咪定(1μg/kg)可提高小儿吸入七氟烷诱导无肌松插管的满意率,插管期间血流动力学更加稳定。 Objective To investigate the effect of intravenous dexmedetomidine injection（1 μg/kg）on the intubating conditions after inhalation induction with sevoflurane 8% and nitrous oxide（N_2O） 50% in children.Methods Totally 122 patients aged 4-10 years with an American Society of Anesthesiologists physical statusⅠ undergoing elective plastic surgery under general anesthesia were randomly divided to dexmedetomidine group（intraveneously injected with dexmedetomidine 1μg/kg） and control group（injected with normal saline）by using the random sampling table.On arrival of the operating room,anesthesia was induced with sevoflurane8% and N_2O 50% in oxygen 50%.When the patient became unconscious,the intravenous cannula 24#was inserted on the dorsum of hand.One minute later,laryngoscopy and tracheal intubation were performed.The intubating conditions were assessed by the scoring system in the previous study.Results The rates of acceptable conditions were 97% and 90% in dexmedetomidine group and in control group（P=0.143）,and the rates of excellent conditions were 82% and 67%（P=0.04）,respectively.In dexmedetomidine group,there were no significant differences of mean arterial presser and heart rate between the time-point of before intubation and the timepoint of immediately after intubation.Conclusion Intravenous bolus of dexmedetomidine（1 μg/kg） can effec-tively improve the intubating conditions after inhalation induction of sevoflurane 8% and N_2O 50% in children and make the hemodynamics more stable during tracheal intubation.

关 键 词： 右美托咪定 七氟烷 气管插管 小儿