关键词: 儿童口腔, 全身麻醉, 七氟烷, 右美托咪定

Abstract: PURPOSE: To evaluate the effect of dexmedetomidine combined with sevoflurane for general anesthesia during dental treatment in pediatric patients. METHODS: One hundred and twenty pediatric patients undergoing dental treatment were randomly divided into sevoflurane combined dexmedetomidine group（D group）and sevoflurane group (S group), 60 children in each group. Children in group D inhaled 4%-6% sevoflurane and intravenously received fentanyl 1 μg/kg, midazolam 0.1 mg, propofol 2 mg/kg, rocuronium 0.3 mg/kg, then tracheal intubation was performed when eyelash reflex disappeared, the density of sevoflurane was reduced to 2%-3% for maintenance. When the treatment started, 9-12 mg/(kg·h) of propofol was pumped, and 1 μg/kg of dexmedetomidine was pumped for 15 minutes, then the dose was reduced to 0.5 μg/(kg·h) until the end of treatment. Children in group S didn't receive dexmedetomidine pumped. During the procedure, HR, MAP, and Ramsay scale were recorded at baseline (T1), loss of eyelash reflex (T2), after dexmedetomidine was pumped for 10 mins (T3), operation initiation (T4) and the end of operation (T5). The operation time, recover and extubation time, pediatric anesthesia emergence delirium scale (PAED) in pediatric anesthesia care unit (PACU) were recorded. SPSS 20.0 software package was used for statistical analysis. RESULTS: There was no significant difference in operation time between the two groups. At T3-T5, MAP and HR were significantly lower, but Ramsay scale was significantly higher in group D than in group S (P<0.05). The recover and extubation time were significantly longer in group D (P<0 .05). In PACU, PAED scale was significantly lower in group D than in group S (P<0.05). CONCLUSIONS: Dexmedetomidine combined with sevoflurane not only stabilize hemodynamic parameters, but also reduce the impact on respiration during dental treatment in pediatric patients.

Key words: Pediatric dentistry, General anesthesia, Sevoflurane, Dexmedetomidine