术前经口腔黏膜喷雾不同剂量右美托咪定在小儿扁桃体腺样体切除术围麻醉期的效果对比

Comparison of the effects of different doses of dexmedetomidine administered by oral mucosal spray before operation during the perianesthesia period of pediatric tonsil adenoidectomy

目的探讨小儿扁桃体腺样体切除术患儿术前经口腔黏膜予以不同浓度右美托咪定后围麻醉期的镇静效果及不良反应的观察。方法选取我院2018年6月~2019年6月扁桃体和(或)腺样体手术患儿120例,将其随机分为四组,每组30例,入室前60min经口腔黏膜予以不同浓度的右美托咪定喷雾,A组(0),B组(1μg/kg),C组(2μg/kg),D组(4μg/kg)。分别于给药前和给药后20、40、60min记录患儿的镇静深度(OAA/S),记录术后麻醉复苏时间及不良反应。结果与A、B组相比较,C、D组镇静效果更好,P<0.05;给药后各组呼吸恢复时间未见明显改变,B、C、D组拔管时间、定向力恢复时间较A组有所延长,D组较C组拔管及定向力恢复时间明显延长,P<0.05;C、D组不良反应发生率低于A、B组,P<0.05。结论经口腔黏膜予以右美托咪定(2μg/kg)能为扁桃体腺样体手术围麻醉期患儿提供更好的镇静效果,减少不良反应。

Objective To investigate the sedative effect and adverse reactions of different doses of dexmedetomidine administered by oral mucosal spray before operation during the perianesthesia period of pediatric tonsil adenoidectomy.Methods 120 pediatric patients who underwent tonsil and/or adenoid surgery from June 2018 to June 2019 in our hospital were selected and randomly divided into four groups,30 in each group.The following concentrations of dexmedetomidine spray were applied to the oral mucosa 60 minutes before entering the operating room:group A(0),group B(1μg/kg),group C(2μg/kg)and group D(4μg/kg).The sedation depth(OAA/S)of the pediatric patients was recorded before administration and 20,40 and 60 minutes after administration,respectively,and the postoperative anesthesia recovery time and adverse reactions were recorded.Results Compared with group A and group B,the sedative effects were better in group C and D(P<0.05).There was no significant change in respiratory recovery time after administration.The extubation time and directional force recovery time in group B,C and D were longer than those in group A,and the extubation time and directional force recovery time in group D were significantly longer than that in group C(P<0.05).The incidences of adverse reactions in group C and D were lower than those in group A and B(P<0.05).Conclusion Administration of dexmedetomidine(2μg/kg)via oral mucosa can provide better sedative effect and reduce adverse reactions for pediatric patients undergoing tonsil adenoidectomy during the perianesthesia period.