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目的比较右美托咪定注射剂和丙泊酚注射剂在小儿磁共振(MRI)检查中的镇静效果。方法将90例1~6岁进行3.0TMRI检查的患儿随机分为试验组和对照组,每组45例。对照组静脉泵注丙泊酚负荷剂量2.5 mg·kg~(-1),给药时间10 min,接着给予80~100μg·kg~(-1)·min~(-1)维持;试验组静脉泵注右美托咪定负荷剂量1μg·kg~(-1),给药时间10 min,接着给予0.3~0.8μg·kg~(-1)·h~(-1)维持。记录给药前(T0)、给药后10 min(T_1)、开始检查前(T_2)、MRI检查开始后5min(T_3)、MRI检查完毕(T_4)、患儿返回病房(T_5)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(Sp O2)、呼吸频率(RR)、镇静起效时间、苏醒时间、苏醒后烦躁发生率、药物不良反应、MRI检查质量和时间。结果与T0比较,试验组患儿T_1-T_4的MAP和HR降低(P<0.05),T5恢复至基础水平;对照组在T_1-T_4MAP、RR降低(P<0.05),T_5时点恢复至基础水平,与试验组比较,在T1-T3MAP和RR显著低于试验组(P<0.05),在T_1-T_4HR显著高于试验组(P<0.05)。对照组镇静起效时间和苏醒时间显著短于试验组(P<0.05),但苏醒后烦躁的发生率和低氧饱和度的发生率显著高于试验组(P<0.05)。试验组MRI的检查质量显著高于对照组,检查时间显著短于对照组(P<0.05)。结论与丙泊酚注射剂相比,右美托咪定注射剂在小儿磁共振检查中能提供满意的镇静深度,对患儿呼吸和血流动力学影响小,药物不良反应发生率低,但是镇静的起效时间和苏醒时间长于丙泊酚。
Objective To compare the sedation of dexmedetomidine and propofol in children with magnetic resonance imaging (MRI). Methods Totally 90 infants who underwent 3.0TMRI from 1 to 6 years old were randomly divided into experimental group and control group, with 45 cases in each group. In the control group, the propofol loading dose was 2.5 mg · kg -1, and the administration time was 10 min, followed by the maintenance of 80 ~ 100 μg · kg -1 · min -1. Dexmedetomidine was infused in a dose of 1 μg · kg ~ (-1) for 10 min and then maintained at 0.3 ~ 0.8 μg · kg -1 · h -1. The mean arterial pressure (T_5), the mean arterial pressure (T_5) of the children returned to the ward (T_5) after the MRI examination (T_4) and before the start of the test (T_2) MAP, HR, Sp O2, respiratory rate (RR), sedation onset time, recovery time, incidence of irritability after wakefulness, adverse drug reactions, quality and time of MRI examination. Results Compared with T0, the MAP and HR of T 1 -T 4 in the experimental group decreased (P <0.05) and T5 recovered to the basal level. In the control group, RR decreased (P <0.05) at T 1 -T 4 MAP and restored to the baseline at T 5 Compared with the experimental group, the T1-T3MAP and RR were significantly lower (P <0.05) and T_1-T_4HR were significantly higher in the T1-T3 group than those in the experimental group (P <0.05). The onset time and recovery time in the control group were significantly shorter than those in the experimental group (P <0.05). However, the incidence of irritability and hypoxemia in the control group was significantly higher than that in the experimental group (P <0.05). The quality of MRI in the experimental group was significantly higher than that in the control group, and the examination time was significantly shorter than that in the control group (P <0.05). Conclusion Compared with propofol injection, dexmedetomidine injection can provide satisfactory depth of sedation in pediatric MRI, little effect on respiration and hemodynamics, low incidence of adverse drug reactions, but sedation Time to onset and recovery longer than propofol.