Feng Jumian,Wang Huaizhen,Peng Liangming,et al.Application of dexmedetomidine combined with sufentanil in ultra-fast track cardiac anesthesia for infants and young children[J].Journal of Clinical Pediatric Surgery,,19():1032-1037.[doi:10.3969/j.issn.1671-6353.2020.11.014]
Application of dexmedetomidine combined with sufentanil in ultra-fast track cardiac anesthesia for infants and young children
- CLC:
- R729;R614
- Abstract:
- Objective To observe the clinical effects of dexmedetomidnie combined with sufentanil in ultra-fast track cardiac anesthesia for infants and young children.Methods A total of 130 infants and young children patients undergoing opening atrial septal defect (ASD) repair and (or) ventricular septal defect (VSD) repair by cardiopulmonary bypass (CPB),were randomized into a dexmedetomidnie UFTCA group and a conventional anesthesia group according to the random number table method (65 patients in each group).Patients in UFTCA group were received a continuous infusion dose of 1 mcg/kg/h dexmedetomidine following induction until cross clamp releasing,then decreased the dose of dexmedetomidine to 0.3 mcg/kg/h until the end of the operation;the post operation analgesia was dexmedetomidine combined with sufentanil.Patients in conventional anesthesia group were received a comtinuous infusion of the same volume of normal saline until the end of the operation,the drug of analgesia was sufentanil.The doses of sufentanil,hemodynamic indexes,postoperative hospitalization conditions,scores of FLACC,scores of Ramsay and the lactic acid (Lac),arterial partial arterial of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2) 2 hours post-operation were recorded and compared between the two groups.Results The dose of sufentanil in UFTCA group was significantly lower than that in conventional anesthesia group (P<0.05).There were no significant differences in the heart rate (HR)and mean arterial pressure (MAP) between the two groups at the time of before induction(T1),after induction(T2),skin incision(T3),during CPB(T4),end of CPB(T5),end of operation(T6)(P>0.05).The length of extubation post-operation,cardiac intensive care unit (CICU) stay,hospital stay and hospitalization expenses in UFTCA group were all significantly less than those in conventional anesthesia group (P<0.05).There were no significant differences in the scores of FLACC at the first and second day post-operation between the two groups(P>0.05).The scores of Ramsay in UFTCA group were significantly higher than those in conventional anesthesia group at the first and second day post-operation respectively(P<0.05).The Lac 2 hours post-operation in UFTCA group was significantly lower than that in conventional anesthesia group (P<0.05).Conclusion The application of dexmedetomidine combined with sufentanil in UFTCA for infants and young children is effective,and can decrease the perioperative dose of opioids,ensure stable hemodynamics,shorten extubation time,provide good postoperative sedation and analgesia effect,improve postoperative oxygenation balance and internal environment,with no obvious adverse reactions.
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Memo
收稿日期:2019-09-01。
基金项目:广州市科技计划项目（编号：201803010025）
通讯作者:宋兴荣,Email:songxingrong@gwcmc.org