右美托咪定滴鼻对儿童七氟烷全麻苏醒期躁动的预防效果观察

Observation on effect of demetomidine nasal drip for preventing of awakening restlessness in children with seflurance general anesthesia

目的观察分析右美托咪定滴鼻在预防小儿七氟烷全身麻醉(全麻)苏醒期躁动中的应用效果。方法 98例行全麻手术患儿,随机分为对照组与实验组,每组49例。两组患儿入室后均行七氟烷麻醉,实验组患儿手术结束前10 min经鼻滴入右美托咪定0.3μg/kg,对照组滴入等量的氯化钠注射液。对比两组患儿行麻醉处理后的手术情况、躁动发生情况、Ramsay评分以及视觉模拟评分法(VAS)评分。结果两组患儿手术时间、麻醉恢复室(PACU)停留时间比较差异无统计学意义(P>0.05);实验组患儿苏醒时间长于对照组,差异具有统计学意义(P<0.05)。实验组患儿躁动发生率为14.3%,显著低于对照组的38.8%,差异具有统计学意义(X^2=7.538, P<0.05)。拔出喉罩时(T1)、滴鼻结束后10 min(T2)时,实验组患儿Ramsay评分、VAS评分均显著低于对照组,差异具有统计学意义(P<0.05)。结论采用右美托咪定滴鼻,能够有效预防小儿七氟烷全麻苏醒期躁动的发生,改善患儿的预后,值得临床广泛推广应用。

Objective To observe and analyze the application effect of demetomidine nasal drip for preventing of awakening restlessness in children with seflurance general anesthesia. Methods A total of 98 children with general anesthesia were randomly divided into control group and experimental group, with 49 cases in each group. Both groups received anesthesia of seflurance. The experimental group received 0.3 μg/kg of demetomidine nasal drip at 10 min before completion of operation, and the control group received an equal amount of sodium chloride injection. Comparison were made on operation condition, occurrence of restlessness, Ramsay score and visual analogue scale(VAS) score after anesthesia between the two groups. Results Both groups had no statistically significant difference in operation time, post-anesthesia care unit(PACU) residence time(P>0.05). The experimental group had longer wake-up time than the control group, and the difference was statistically significant(P<0.05). The experimental group had significantly lower incidence of restlessness as 14.3% than 38.8% in the control group, and the difference was statistically significant(X^2=7.538, P<0.05). At removal of laryngeal mask(T1) and 10 min after completion of nasal drip(T2), the experimental group had significantly lower Ramsay score and VAS score than the control group, and their difference was statistically significant(P<0.05). Conclusion Demetomidine nasal drip can effectively prevent occurrence of awakening restlessness in children with seflurance general anesthesia and improve the prognosis of children. It is worthy of clinical wide promotion and application.