【摘要】 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1⁶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80¹00μg·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0.3⁰.8μg·kg^-1·h^-1维持。记录给药前（T0）、给药后10 min（T₁）、开始检查前（T₂）、MRI检查开始后5min（T₃）、MRI检查完毕（T₄）、患儿返回病房（T₅）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T₁-T₄的MAP和HR降低（P<0.05）,T5恢复至基础水平;对照组在T₁-T₄MAP、RR降低（P<0.05）,T₅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T₁-T₄HR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。更多还原

【Abstract】 Objective To compare sedative effects of dexmedetomidine injection and propofol injection for sedation in paediatrics undergoing magnetic resonance imaging（ MRI） procedure. Methods Ninety children aged between 1-6 years old were randomly allocated to receive sedation with either treatment group（ n = 45） or control group（ n = 45）. The loading dose of dexmedetomidine 1 μg · kg^-1was administered for 10 min and followed by continuous infusion 0. 3-0. 8 μg · kg^-1·h^-1in the treatment group and the loading dose of propofol 2. 5 mg ·kg^-1was administered for 10 min,then followed by continuous infusion 80^-100μg·kg^-1·min^-1in the control group. Mean arterial pressure（ MAP）,heart rate（ HR）,pulse oxygen saturation（ Sp O₂）,respiratory rate（ RR）,onset of seditive time,recover time,the frequence of post-examination agitation,adverse drug reaction and the quality and duration of MRIexamination were recorded at pre-administration（ T₀）,5 min after administration（ T₁）,pre-examination（ T2）,5 min after examination（ T₃）,at the end of examination（ T4） and after returning to patient ward（ T₅）. Results In treatment group,MAP and HR decreased significantly in T₁-T₄ than T0and returned to baseline in T5（ P < 0. 05）. In control group,MAP and RR decreased significantly in T₁-T₄ than T0and returned to baseline in T₅（ P < 0. 05）,but MAP,RR in control group were significantly lower in T₁-T₃,while HR was significantly higher in T₁-T₄ than in treatment group. The onset of sedation time and recover time in control group were significantly shorter than treatment group,but the frequence of post-examination agitation and incidence of adverse drug reaction were higher than treatment group.The quality of MRI examination of the treatment group was significantly higher than the control group,while the duration of the treatment group was shorter than the control group（ P < 0. 05）. Conclusion Compared with propofol injection,dexmedetomidine injection can provide adequate sedation in paediatrics during MRI exammination without haemodynamic or respiratory side effects,but the onset of sedation time and recover time was longer than propofol.更多还原