天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (9): 984-987.doi: 10.11958/20170543

• 临床研究 • 上一篇    下一篇

右美托咪定和氯胺酮在小儿扁桃体切除术中的作用

蒋铭 1，杨现会 2△，王军 1，周彪 3，颜朋朋 1   

  1. 1 洛阳市第一中医院麻醉科（邮编 471000）；2 郑州大学第二附属医院麻醉科；3 洛阳市中心医院麻醉科
  • 收稿日期:2017-05-08 修回日期:2017-06-23 出版日期:2017-09-15 发布日期:2017-09-25
  • 通讯作者: 杨现会 E-mail:xianhui.yang@aol.com

The effect of dexmedetomidine and ketamine on tonsillectomy in children

  • Received:2017-05-08 Revised:2017-06-23 Published:2017-09-15 Online:2017-09-25

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摘要： 摘要：目的 观察比较右美托咪定、氯胺酮对小儿扁桃体切除术麻醉苏醒期躁动和镇痛的效果。方法 选择 ASA Ⅰ~Ⅱ级择期行扁桃体及腺样体切除术的患儿 60 例作为研究对象，随机分成 P、D、K 共 3 组，术中分别给予适 量的安慰剂、右美托咪定、氯胺酮，记录 3 组患儿在麻醉前（T0）、拔管时（T1）、拔管后 5 min（T2）、10 min（T3）、15 min （T4）、30 min（T5）的平均动脉压（MAP）和心率（HR），统计 3 组患儿的苏醒时间、恶心呕吐情况、躁动评分和疼痛评分 等。结果 在 T1、T2、T3时，D 组和 K 组的 MAP 和 HR 均较 P 组更加稳定（P<0.05）；D 组、K 组躁动评分、躁动发生 率、恶心呕吐发生率均低于 P 组，且 D 组低于 K 组（均 P<0.05）。结论 右美托咪定和氯胺酮在麻醉苏醒期均能起 到一定的镇痛作用，并能降低麻醉苏醒期躁动、恶心呕吐不良的发生和疼痛评分，且右美托咪定抑制躁动和恶心呕 吐不良率的发生效果更明显。

关键词: 氯胺酮, 扁桃体切除术, 儿童, 右美托咪定

Abstract: Abstract：Objective To observe and contrast the effects of dexmedetomidine and ketamine on the restlessness and analgesia during recovery period of anesthesia after tonsillectomy in children. Methods Sixty ASA Ⅰ-Ⅱ child patients underwent tonsillectomy and adenoidectomy were randomly divided into three groups, group P (appropriate amount of placebo was given in the operation), group D (dexmedetomidine) and group K (ketamine). Data of mean arterial pressure and heart rate of three groups were documented before anesthesia (T0), during extubation (T1), 5 min (T2), 10 min (T3), 15 min (T4) and 30 min (T5) after extubation were recorded. The analepsia time, adverse reactions, restlessness score and pain score were collected in three groups of patients. Results Compared with group P, values of mean arterial pressure and heart rate were more stable at T1, T2 and T3 in groups D and K (P＜0.05). The restlessness score, incidence of restlessness and adverse reactions were lower in groups D and K than those in group P (P＜0.05), and which were lower in group D than those of group K (P＜0.05). Conclusion Both dexmedetomidine and ketamine can play an analgesic role in recovery period of anesthesia and reduce restlessness, adverse reactions and pain score in child patients. Moreover, dexmedetomidine is more effective on inhibiting restlessness and adverse reactions.

Key words: ketamine, tonsillectomy, child, dexmedetomidine