目的：研究七氟烷联合右美托咪啶对眼科患儿全身麻醉苏醒期躁动(EA)的影响。

方法：抽取2018-05/12我院84例择期行眼科手术的患儿为研究对象，随机分为研究组和对照组各42例。均给予吸入七氟烷维持全身麻醉，麻醉插管完成后研究组患儿给予右美托咪啶0.5μg/kg静脉恒速泵注，对照组患儿给予等容量生理盐水。获取苏醒期心率(HR)、平均动脉压(MAP)及血清应激反应指标去甲肾上腺素(NE)、皮质醇(Cor)监测数据，并记录麻醉恢复、EA及并发症发生情况。

结果：对照组患儿清醒时、拔管后1、5、10min的HR、MAP均明显波动，各时点有明显差异(P<0.05)，而研究组无差异(P>0.05)，且研究组各时点HR、MAP均低于对照组(P<0.05)。研究组患儿清醒时、拔管后10min血清NE、Cor水平均低于对照组(P<0.05)。两组患儿自主呼吸恢复时间、清醒时间无差异(P>0.05)，但与对照组相比，研究组患儿拔管时间短，拔管质量评分低(P<0.05)。研究组患儿EA发生率仅12%，低于对照组的31%(P<0.05)，EA程度及并发症发生率无差异(P>0.05)。

结论：七氟烷联合右美托咪啶可有效稳定眼科患儿全身麻醉苏醒期血流动力学，减轻应激反应，有效降低EA发生率，且不影响麻醉恢复质量，安全性较高，但需注意过度镇静现象。

METHODS: Totally 84 children underment elective ophthalmic surgery in the hospital from May to December 2018 were selected as the research objects. They were randomly divided into study group and control group with 42 cases in each group. All patients in haled sevoflurane to maintain general anesthesia. After anesthesia intubation, children in the study group were treated with intravenous injection of 0.5μg/kg of dexmedetomidine in a constant-speed while children in the control group were treated with same volume of normal saline. The monitoring data of heart rate(HR), mean arterial pressure(MAP)and serum stress response indexes such as norepinephrine(NE)and cortisol(Cor)during recovery period were obtained. The anesthesia recovery, EA and occurrence of complications were recorded.

RESULTS: There were obvious fluctuations of HR and MAP in the control group while awake, at 1min, 5min and 10min after extubation. There were significant differences at different time points(P<0.05), while there was no significant difference in study group(P>0.05). HR and MAP were significantly lower than those in control group at each time point(P<0.05). Levels of serum NE and Cor in study group while awake and at 10min after extubation were significantly lower than those in control group(P<0.05). There was no significant difference in spontaneous breathing recovery time or awake time between the two groups(P>0.05). Compared with the control group, the extubation time was significantly shorter and score of extubation quality was significantly lower in the study group(P<0.05). The incidence of EA in study group was significantly lower than that in control group(12% vs 31%)(P<0.05). There was no significant difference in the severity of EA or incidence of complications(P>0.05).

CONCLUSION: Sevoflurane combined with dexmedetomidine can effectively stabilize hemodynamics of children under went general anesthesia in ophthalmology department during recovery period, and reduce stress response, thus effectively reducing the incidence of EA, without affecting anesthesia recovery quality and with high safety. However, excessive sedation should be payed attention to.