Feasibility of Dexmedetomidien in facilitating mextubation in infants after TOF repair operation

YANG Qi; MEI Ju; TANG Min

doi:10.3969/j.issn.1672-5301.2017.02.019

Abstract：Objective To compare the outcome between two sedation methods,Morphine-Midazolam and Dexmedetomidine,in infants after TOF repair operation.Methods We retrospectively analyzed the clinical data of 68 infants who underwent TOF repair operation in Xinhua Hospital in 2014 and 2015.There were 39 males and 29 females aged 6.2-15.5(10.1±2.1)months.Sedation support was started when the patients started to breathe spontaneously or had body movement.There were 32 patients in group A with Morphine-Midazolam(Morphine 0.1-0.5 mg·kg-1·h-1,Midazolam 0.1-0.5 mg-1·kg·h-1),and 36 patients in group B with Dexmedetomidine 0.2～0.7 μg·kg-1 ·h-1.In group A,the sedation support stopped when the patients started breathing exercises.While in group B,the sedation support was given until 1 h after extubation.Results There was no statistical difference between two groups in demography data and operative data.The extubation time was shorter in group B (36.12 h vs 20.18 h,P＜0.05).Patients in group B were more likely to cooperate the extubation.There was no difference in HR and MAP before the extubation.In group A,HR and MAP increased from the extubation,and then fell gradually.There was no difference between two groups in HR until 6 h after extubation and in MAP until 2 h after extubation.In group B,HR and MAP changed more smoothly.After extubation,there were 3 patients reintubated in group A due to the extubation related complications(Respiratory depression in 1 patient,severe laryngeal edema in 2 patients),while none was reintubated in group B.Conclusion The sedation method,Dexmedetomidine,is better than Morphine-Midazolam for infants after TOF repair operation.