上海交通大学学报(医学版)

• 论著(临床研究) • 上一篇    下一篇

法洛四联症患儿术前口服咪达唑仑、氯胺酮和右美托咪定的临床观察

李敏,王燕婷,张马忠,白洁,刘配配,孙瑛   

  1. 上海交通大学 医学院附属上海儿童医学中心麻醉科,上海 200127
  • 出版日期:2017-01-28 发布日期:2017-01-19
  • 通讯作者: 孙瑛,电子信箱:yingsun821@163.com。
  • 作者简介:李敏(1991—),女,硕士生;电子信箱:15900906503@163.com。
  • 基金资助:

    上海市浦东新区科技发展基金(PKJ2015-Y02)

Clinical observation of oral premedication with midazolam, ketamine, and dexmedetomidine in children with tetralogy of Fallot

LI Min, WANG Yan-ting, ZHANG Ma-zhong, BAI Jie, LIU Pei-pei, SUN Ying   

  1. Department of Anesthesiology, Shanghai Children’s Medical Center , Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2017-01-28 Published:2017-01-19
  • Supported by:

    Science and Technology Development Fund of Pudong New Area,Shanghai,PKJ2015-Y02

摘要:

目的 ·比较法洛四联症患儿术前口服咪达唑仑、氯胺酮和右美托咪定的临床有效性与安全性。方法 ·择期行法洛四联症纠治术的60例患儿随机分为3组,分别给予口服咪达唑仑(0.5 mg/kg)、氯胺酮(5 mg/kg)和右美托咪定(5 μg/kg),每组20例。观察并记录给药接受度,给药前及给药后不同时间点的心率(HR)、脉搏血氧饱和度(SpO2)、镇静评分,用药30 min后的分离评分及静脉置管评分。结果 ·右美托咪定组给药接受度显著高于咪达唑仑组和氯胺酮组(P<0.05),3组镇静起效时间的差异无统计学意义(P>0.05)。氯胺酮组的分离满意率和置管满意率显著高于咪达唑仑组和右美托咪定组(P<0.05)。与给药前基础值比较,3组患儿给药后各时点的HR、SpO2均无明显变化(P>0.05)。结论 ·术前口服咪达唑仑、氯胺酮和右美托咪定均可为法洛四联症患儿提供良好的镇静效果,口服氯胺酮患儿的分离满意率与置管满意率最高。

关键词: 术前用药, 咪达唑仑, 氯胺酮, 右美托咪定, 法洛四联症

Abstract:

Objective · To compare the efficacy and safety of oral premedication with midazolam (MID), ketamine (KET), and dexmedetomidine (DEX) in children with tetralogy of Fallot (TOF). Methods · Sixty children undergoing selective primary repair for TOF were randomly assigned to orally receiving MID (0.5 mg/kg, Group M), KET (5 mg/kg, Group K), and DEX (5 μg/kg, Group D) with twenty children in each group. The acceptance of administration, HR, SpO2, and sedation score before administration and at different time points after administration, scores of separation and intravenous cannulation 30 min after administration were observed and recorded. Results · The acceptance of administration was significantly higher in Group D than in other two groups (P<0.05). There was no significant difference in sedation onset time among three groups (P>0.05). The satisfaction rates of separation and intravenous cannulation were significantly higher in Group K than in Group D and Group M (P<0.05). There were no significant differences between HR and SpO2 at different time points after administration and baseline values before administration in three groups. Conclusion · Oral premedication with MID, KET, and DEX can provide good sedation for children with TOF. Children receiving oral KET have the highest satisfaction rates of separation and intravenous cannulation.

Key words: premedication, midazolam, ketamine, dexmedetomidine, tetralogy of Fallot