摘要
Objective:To observe the effect of dexmedetomidine on the stress reaction caused by sevoflurance anesthesia during the perianesthesia period in school-age children with different personality characteristics.Methods:A total of 160 children who were admitted in our hospital for transumbilical single-port laparoscopic hernia inner ring ligation were included in the study and randomized into dexmedetomidine (D) group and midazolam (M) group. The children were performed with Eysenck Personality Questionnaire before operation (children edition). Children were divided into the emotion group (group I) and stable group (group II). The operation was performed under sevoflurance inhalation anesthesia. Patients in DI and DII groups were given 1 μg/kg DEX, MI and MII groups were given 0.05 mg/kg midazolam, for 15 min. MAP and HR one day before operation (T0), before anesthesia induction (T1), 1 min after pneumoperitoneum establishment (T2), the time after pulling out the laryngeal mask (T3), and the time after shifting from the recovery room (T4) were recorded. A volume of 6 mL venous blood 1 d before operation and 4 h after operation was collected. Blood sugar concentration, cortisol and IL-6 levels were detected.Results:MAP at T1, T2, T3, and T4 in DI and MI groups were significantly elevated when compared with at T0. MAP at T2 and T3 in DII group was significantly elevated when compared with at T0. MAP at T2, T3, and T4 in MII group was significantly elevated when compared with at T0. When compared with DI group, MAP at T1, T2, and T3 in DII group was significantly reduced;MAP at T2, T3, and T4 in MI group was significantly elevated;MAP at T1 in MII group was significantly reduced. When compared with DII group, MAP at T2, T3, and T4 in MI and MII groups was significantly elevated. HR at T1, T2, T3, and T4 was significantly elevated when compared with at T0. When compared with DI group, HR at T1, T2, and T3 in DII group was significantly reduced;HR at each timing point in MI group was significantly elevated;HR at T1 in MII group was significantly reduced, while at T2, T3, and T4 was significantly elevated. When compared with DII group, HR at each timing point in MI group was significantly elevated;HR at T2, T3, and T4 in MII group was significantly elevated. Except for DII group, the blood sugar, cortisol, and IL-6 levels were significantly elevated when compared with before operation. When compared with D1 group, the blood sugar and cortisol levels at T1 in DII group were significantly reduced;the blood sugar, cortisol, and IL-6 levels at T1 in MI and MII groups were significantly elevated. When compared with DII group, the blood sugar, cortisol, and IL-6 levels at T1 in MI and MII groups were significantly elevated.Conclusions:Application of hydrochloric DEX in sevoflurance anesthesia in children can effectively inhibit the excitability of sympathetic nervous system caused by operation, alleviate the stress reaction, and maintain the stability of hemodynamics, which is benefit for the postoperative rehabilitation.
