Abstract：Objective To evaluate the efficacy and safety of administration of different doses of dexmedetomidine in pediatric patients who need a preoperative stereotaxic procedure by magnetic resonance imaging (MRI). Methods 90 pediatric patients who needed stereotaxic check by MRI under basic anesthesia were randomly divided into three groups, D1, D2 and D3, 30 subjects per group. All subjects were given propofol 1-3 mg/kg to get thorough sedation. The loading dose of dexmedetomidine was 1 μ k/ kg, the maintenance dose in D1 group was 0.5 μg/(kg·h), D2 group was 0.7 μg/(kg·h), and D3 group was 1.0 μg/(kg·h). After they fell asleep, all subjects were given local anesthesia to put on the stereotaxic instrument. Patients’ NBP, HR, RR and SPO2 were recorded at several necessary time points, the dosage of propofol, the cases who needed additional propofol were recorded as well. Additionally, we also observed the incidence of adverse events such as respiratory depression, unexpected early recovery and postoperative agitation. Results Compared with D1 group ,the dosage of propofol were significantly reduced in D2 group and D3 group( P<0.01 ). In D1 group, there were 17 subjects who needed additional propofol, 10 subjects had respiratory depression, and among them one patient had to give up the examination because of severe respiratory depression .There were only 5 cases in D2 group who needed additional propofol, obviously less than in D1 group(P<0.01); no respiratory depression occurred in D2 group(P<0.05 ).All the children in D3 group finished stereotaxic check without additional propofol, no respiratory depression occurred as well (P<0.05 ). In addition, the heart rate in D3 group dropped somewhat during the checking time, but still within the normal range. There was no significant difference in postoperative recovery status among these three groups. Conclusions During stereotaxic checking period by MRI in pediatric patients, the maintenance dose1.0 μg/(kg·h) of dexmedetomidine after a loading dose of 1.0 μg/kg can not only reduce the additional injection of propofol, but also ensure the children’s quietness and security without respiratory depression.
李占军, 韩曙君, 董兰, 刘多辉, 李立纲, 蔡俊刚. 不同剂量右美托咪定对小儿MRI下脑立体定向术麻醉效果比较[J]. 武警医学, 2015, 26(7): 696-698.
LI Zhanjun, HAN Shujun, DONG Lan, LIU Duohui, LI Ligang, CAI Jungang. A comparison of different doses of dexmedetomidine in pediatric patients undergoing stereotaxic procedure by MRI. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(7): 696-698.
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