护理干预联合右美托咪定对小儿全麻苏醒期躁动的影响

Influence of Emergence Agitation in Children's Nursing Intervention Combined With Dexmedetomidine

目的研究护理干预联合右美托咪定对小儿全麻苏醒期躁动的影响。方法行腹腔镜下斜疝颈高位结扎术小儿患者60例,将其随机分为A、B、C三组,每组20例。A组为护理干预+术后右美托咪定注射组,B为等剂量生理盐水对照组;C组为术后右美托咪定注射组。记录患者术前(T1)、拔气管导管后1 min(T2),拔气管导管后30 min(T3)时的血压(MAP),心率(HP),血氧饱和度(SPO_2)的变化情况,以及在T2,T3时麻醉后恢复评分(AS)、躁动-镇静评分(RASS)。结果三组血压(MAP)与心率(HP)在T2、T3时刻关系为A<C<B(P<0.05);在T2,T3时刻各组间RASS评分比较:A组明显于低于B,C两组(P<0.05),C组评分明显低于对照组B(P<0.05);在T2时刻各组间AS评分比较:B组明显于高于A,C两组(P<0.05);在T3时刻,A,B,C三组间AS评分差异无统计学意义;在三组中,各组AS评分T3时刻均高于T2(P<0.05)。结论护理干预联合右美托咪定可有效降低小儿全麻患者苏醒期躁动并能降低患者拔管期心血管反应。

Objective To study the influence of emergence agitation in children the nursing intervention combined with dexmedetomidine.Methods Laparoscopic inguinal hernia neck ligation in 60 cases,which were randomly divided into A,B,C three groups,20 cases in each group.A group for nursing intervention and postoperative injection of dexmedetomidine group;B group used nursing intervention group;C group for postoperative dexmedetomidine group.Were recorded before operation（T1）,extubation after 1min（T2）,tracheal extubation after 30 min（T3）,blood pressure（MAP）,heart rate（HP）,oxygen saturation（Sp O2）,and changes;T2,T3 after anesthesia recovery score（ASES）,restless- sedation score（RASS）.Results The relationship between blood pressure（MAP）and heart rate and heart rate（HP）at T2 and T3 was A〈C〈B（P〈0.05）in three groups;At T2,T3 groups RASS：group A was significantly decreased in B,C groups（P〈0.05）,the score of group C was significantly lower than that of the control group B（P〈0.05）;in T2 time among groups ases score comparison：in group B was significantly in higher than B,C group（P〈0.05）;in T3,a,B,C three groups of ases score difference no statistical significance;in the three groups,groups of ases score T3 were higher than T2（P〈0.05）.Conclusion Nursing intervention combined with dexmedetomidine can effectively reduce pediatric anesthesia recovery period in patients with restless and reducing the extubation on cardiovascular effects.