右美托咪定和咪达唑仑应用于小儿静脉麻醉中的效果比较

Effect comparison of dexmedetomidine and midazolam in intravenous anesthesia for children

目的比较右美托咪定和咪达唑仑用于小儿麻醉中的临床效果。方法在2017年1月至2018年5月进行手术治疗的患儿中挑选70例进行此次实验研究,根据患儿在手术中采取的静脉麻醉药物不同,将患儿平均分为对照组和观察组,每组35例。对照组患儿采用咪达唑仑进行静脉麻醉;观察组患儿采用右美托咪定进行静脉麻醉。观察2组患儿给药后不同时间段的心率、呼吸及血氧饱和度,同时对2组患儿的镇静效果、疼痛程度、镇静满意率、面罩及静脉穿刺接受率进行比较,对2组患儿入睡时间、苏醒时间及术后躁动发生率、不良反应发生率等进行观察比较。结果2组患儿给药后心率、呼吸及血氧饱和度都有明显下降,但2组患儿以上指标在不同时间段差异无统计学意义(P>0.05);观察组患儿镇静效果评分、镇静满意度、面罩及静脉穿刺接受率明显高于对照组,疼痛评分显著低于对照组(P<0.05);2组患儿苏醒时间差异无统计学意义(P>0.05),观察组患儿入睡时间明显早于对照组,术后躁动发生率及不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论用右美托咪定进行小儿静脉麻醉的临床效果比咪达唑仑更加显著,对患儿镇静效果更强,而且患儿术后躁动率和不良反应发生率明显降低,因此,在临床中可以大力推荐这种静脉麻醉的药物。

Objective To compare the clinical effects of dexmedetomidine and midazolam in pediatric anesthesia.Methods A total of 70 children patients who were treated by surgery in our hospital from January 2017 to May 2018 were enrolled in this research.The children patients were divided into control group(n=35)and observation group(n=35)according to different intravenous anesthetics used in the operation.The patients in control group received midazolam intravenous anesthesia,however,the patients in observation group received dexmedetomidine intravenous anesthesia.The heart rate,respiration and oxygen saturation at different time points,the sedative effect,pain degree,sedation satisfaction rate,the receptance rate of mask and venous puncture,falling asleep time,awakening time,the incidence rates of postoperative agitation and adverse reactions were observed and compared between the two groups.Results After administration,the heart rate,respiration and oxygen saturation in both groups were significantly decreased,however there were no significant differences in above indexes in different time points between the two groups(P<0.05).The sedative effect scores,sedation satisfaction degree,the receptance rate of mask and venipuncture rate in observation group were significantly higher than those in control group,however the pain scores in observation group were significantly lower than those in control group(P<0.05).In addition,there was no significantly differences in awakening time between the two groups(P>0.05).The falling asleep time in observation group was significantly earlier than that in control group,moreover,the incidence rates of postoperative agitation and adverse reactions in observation group were significantly lower than those in control group(P<0.05).Conclusion The clinical effects of dexmedetomidine in intravenous anesthesia are significantly obvious than those of midazolam,the former has more obvious sedative effects,with less incidence rates of postoperative agitation and adverse reactions.Therefore the dexmedetomidine in intravenous anesthesia can be popularized widely in clinical practice.