中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (2): 213-216.doi: 10.13418/j.issn.1001-165x.2019.02.020

• 临床研究 • 上一篇    下一篇

右美托咪定复合罗哌卡因对小儿包皮手术中麻醉的效果及对小儿应激反应的影响

钱兴华1,2, 朱智瑞1, 胡智勇1   

  1. 1. 浙江大学医学院附属儿童医院麻醉科,  杭州   314000; 2. 嘉兴市妇幼保健院麻醉科, 浙江  嘉兴   314000
  • 收稿日期:2018-11-14 出版日期:2019-03-25 发布日期:2019-04-29
  • 通讯作者: 胡智勇,主任医师,E-mail: huzhiyong777@zju.edu.cn
  • 作者简介:钱兴华(1983-),男,主治医师,研究方向:儿童临床麻醉,Tel: 13867300738, E-mail: pxh0930@sina.com
  • 基金资助:

    浙江省医药卫生科研基金项目(2017KY443)

Effects of dexmedetomidine combined with ropivacaine on anesthesia and stress response in children

QIAN Xing-hua 1,2, ZHU Zhi-rui 1, HU Zhi-yong 1   

  1. 1. Department of Anesthesiology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou 314000;  2. Department of Anesthesiology, Jiaxing Maternal and Child Health Hospital, Jiaxing 314000, Zhejiang Province, China
  • Received:2018-11-14 Online:2019-03-25 Published:2019-04-29

摘要:

目的 探讨右美托咪定复合罗哌卡因在小儿包皮手术中的麻醉效果及其对术后应激反应的影响。  方法 选取2016年8月~2017年8月本院收治的小儿包皮手术患者98例作为研究对象,随机分成两组,各49例,对照组采用罗哌卡因麻醉,研究组使用右美托咪定复合罗哌卡因实施麻醉。对比两组患儿麻醉镇痛效果、麻醉起效时间,患儿苏醒时间及术后躁动率、术后应激反应情况及不良反应。  结果 研究组麻醉镇痛效果明显优于对照组(P<0.05);研究组患儿的手术时间、麻醉起效时间与术后躁动率明显低于对照组(P<0.05);研究组的血糖、皮质醇与肾上腺素浓度等应激指标显著低于对照组(P<0.05);研究组不良反应产生率明显低于对照组(P<0.05)。  结论 右美托咪定复合罗哌卡因应用于小儿包皮手术麻醉中,可有效降低患儿的应激反应,在镇痛、镇静方面,提供了一种较为安全、便捷的镇痛方法,并发症少,值得临床推广应用。

关键词:  , 右美托咪定,  罗哌卡因,  小儿包皮手术,  麻醉,  效果,  应激反应

Abstract:

Objective To explore the effect of dexmedetomidine combined with ropivacaine on anesthesia in pediatric foreskin surgery and its effect on children's postoperative stress response. Methods A total of 98 cases of pediatric foreskin patients admitted to our hospital from August 2016 to August 2017 were selected as subjects of this study, and randomly divided into two groups with 49 cases each. The control group was treated with ropivacaine anesthesia, and the study group was treated with dexmedetomidine combined with ropivacaine for anesthesia. The analgesic effect, onset time, recovery time, postoperative restlessness rate, stress response and adverse reaction symptoms were compared between the two groups. Results The analgesic effect of the study group was significantly better than that of the control group (P<0.05). Operation time, onset time of anesthesia and postoperative restlessness rate of the study group were significantly lower than those of the control group (P<0.05). Stress indexes such as blood glucose, cortisol and adrenaline concentration in the study group were significantly lower than those in the control group (P<0.05). The adverse reaction rate of the study group was significantly lower than that of the control group (P<0.05). Conclusion The application of dexmedetomidine combined with ropivacaine in pediatric foreskin surgery can effectively reduce the stress response of children. In terms of analgesia and sedation, it provides a relatively safe and convenient analgesic method with few complications, which should be further promoted in clinical application.

Key words: Dexmedetomidine,  Ropivacaine,  Pediatric circumcision,  Anesthesia,  Effect,  Stress response