目的：探讨右美托咪定及曲马多对七氟醚麻醉患儿苏醒期躁动的影响及安全性分析。方法选取2013年3月至2014年3月在本院行手术治疗的100例患儿，随机分为生理盐水组（30例）、右美托咪定组（35例）和曲马多组（35例），所有患儿均采用七氟醚全麻诱导，并于手术结束前20～30分钟对三组患儿分别静脉注射生理盐水、0.3μg/kg右美托咪定、2 mg/kg曲马多。统计各组患儿在围麻醉期的血流动力学变化及苏醒期躁动评分，并比较各组患儿的不良反应，如呼吸抑制、恶心呕吐、反流误吸等。结果右美托咪定组和曲马多组患儿在不同时间点的血流动力学较生理盐水组更为平稳。其中，在T1和T2时间点，各组比较无显著差异。在T2和T3时间点，右美托咪定组和曲马多组患儿的心率和平均动脉压均低于生理盐水组，差异显著（P＜0.05）。右美托咪定组和曲马多组患儿苏醒期躁动发生率均显著低于生理盐水组，差异显著（χ2＝6.6101，4.0899，P均＜0.05）。右美托咪定组和曲马多组患儿苏醒期躁动评分均显著低于生理盐水组，差异显著（t＝12.0292，12.3114，P均＜0.01；t＝13.2458，13.7051，P均＜0.01）。结论右美托咪定及曲马多能够降低七氟醚麻醉患儿苏醒期躁动的发生率，且能够保持患儿的血流动力学稳定，不良反应少，值得临床推广应用。%ObjectiveTo observe the therapeutic effects of tramadol and dexmedetomidine on emergence agitation in children receiving sevolfurane during the awakening period.Method100 cases children in our hospital from March 2013 to March 2014 received sevolfurane for adenotonsillectomy procedure were randomly divided into saline group (30 cases), dexmedetomidine group (35 cases) and tramadol group (35 cases), who were respectively given saline, dexmedetomidine (0.3 μg/kg, injected slowly in 10 minutes) and tramadol (2 mg/kg). We made a statistic analysis comparison of hemodynamic changes at difference time, scores of pediatric anesthesia emergence delirium (PAED) scale and adverse reaction.ResultDexmedetomidine group and tramadol group had a lower rate of emergence agitation, the difference was statistically signiifcant (χ2=6.6101, 4.0899,Pal<0.05); the scores of PAED in dexmedetomidine group and tramadol group were signiifcantly lower than those in saline group during the awakening period, the difference was statistically signiifcant (t=12.0292, 12.3114,P<0.01;t=13.2458, 13.7051,Pal<0.01).ConclusionDexmedetomidine and tramadol on emergence agitation in children receiving sevolfurane during the awakening period is better than saline, with less side effects. It is worth of clinical use.
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