阿托品舌下给药用于早产儿七氟醚全麻眼底检查

摘要

Objective To investigate the effect of sublingual atropine as premedication of sevoflurane anesthesia in premature infants undergoing fundus examination of eyes. Methods Forty-premature infants undergoing examination of fundus of eyes were enrolled in this study. Their gestational age (from the first day of last menstruation period to birth) + after birth age (from birth to the day when examination was performed) = (46 ± 5) weeks. The patients were randomly divided into two groups: group A and group C. Infants in group A were given atropine solution 0. 02 mg/kg sublingually 15 min before anesthesia, while those in group C received the same dose of normal saline. Anesthesia was induced and maintained with 6% and 3% sevoflurane. At before atropine administration(T0) ,5 min(T1), 10 min(T2), 15 min(T3 )after atropine administration HR, SpO2, T, RR, PEtCO2 SEV-e and the incidence of oculocardiac reflex (OCR), the lowest HR during OCR period and the salivary secretion were recorded, and adverse events were evaluated. Results HR and T were significantly increased at T1-T3 in group A than that at T0. Compared with those in group C, HR was significantly increased at T4 -T6, the lowest HR during OCR period was significantly increased, and the salivary secretion significantly decreased in group A. Conclusion Sublingual atropine as premedication can decreas the secretion of salivary and stabalize HR during OCR It is an effective, safe, and easy premedication method in premature infants undergoing fundus examination.%目的 观察术前舌下给予阿托品用于早产儿吸入七氟醚全麻下行眼底检查术对眼心反射和唾液分泌量的影响.方法 选择矫正胎龄(46±5)周拟行眼底检查术的早产儿40例,随机均分为两组:A组和C组.检查前15 min A组舌下给予阿托品0.02 mg/kg,C组舌下给予等容量生理盐水,记录给药前即刻(T0)、给药后5 min(T1)、10 min(T2)、15 min(T3)患儿HR、SpO2、体表体温(T)；吸入6％七氟醚麻醉诱导,吸入3％七氟醚维持麻醉,保留自主呼吸.术毕吸氧直到清醒.记录检查开始时(T4)、检查开始5 min(T5)、检查结束(T6)的HR、SpO2、T、RR、PETCO2、呼气末七氟醚浓度(SEV-e)、眼心反射的例数和眼心反射时最低HR、诱导时间、手术时间、复苏时间及术毕患儿唾液分泌量.结果 T1～T3时A组HR明显快于,T明显高于T0时(P＜0.05或P＜0.01).T4～T6时A组HR明显快于C组,眼心反射时最低HR明显增快,唾液分泌量明显减少(P＜0.05或P＜0.01).结论 早产儿行全麻眼底检查术前舌下给予阿托品0.02mg/kg,起效快,操作简便无痛苦；明显减少唾液分泌量,降低眼心反射引起的HR减慢程度.