七氟烷联合右美托咪定经鼻给药在小儿麻醉诱导中的应用

Application of Sevoflurane Combined with Dexmedetomidine in Induction of Anesthesia in Children

目的 观察术前右美托咪定经鼻给药联合七氟烷诱导对小儿手术术前、术后的影响.方法 选取2018年8月至2019年4月重庆市石柱土家族自治县人民医院收治的30例年龄2~6岁、美国麻醉医师协会(ASA)分级I级、全麻下择期手术的患儿按照随机数字表法分为D1组和D2组,各15例.评估患儿入手术室前与父母的分离情况,观察用药后小儿心率(HR)和血氧饱和度(SpO2)变化.记录小儿苏醒后10 min(T1)、小儿苏醒后30?min(T2)的HR、Sp02.记录小儿躁动评分及躁动率.结果 2组术前术后SpO2、苏醒时间比较均无统计学意义(P> 0.05).术前,D1组与父母分离的满意度为100.00%,明显高于D2组的46.67%,差异有统计学意义(P<0.05).术后,D1组苏醒期躁动率6.67%,明显低于D2组的26.67%,其中躁动评分D1组明显低于D2组,比较差异有统计学意义(P<0.05).结?论 七氟烷联合经鼻雾化喷入右美托咪定诱导可以明显减少患儿术前焦虑,无呼吸抑制且易与父母分离.同时还可以有效预防患儿术后躁动,是安全有效的小儿麻醉诱导方法 .

Objective To observe the effect of preoperative dexmedetomidine combined with sevoflurane on preoperative and postoperative pediatric surgery.Methods From August 2018 to April 2019,30 children aged from 2 to 6 years old,with ASA level I,admitted to the people's hospital of shizhu tujia autonomous county,chongqing,who underwent elective surgery under general anesthesia were divided into D1 group and D2 group,with 15 cases each,according to the random number table method.To evaluate the separation of the children from their parents before entering the operating room,and to observe the changes in the children's heart rate(HR)and blood oxygen saturation(SpO2)after medication.HR and Sp02 were recorded at 10 min(T1)and 30 min(T2)after resuscitation.The score and rate of children's agitation were recorded.Results There was no significant difference in SpO2 and recovery time between the two groups(P>0.05).Before operation,the satisfaction of separation between D1 group and parents was 100%,significantly higher than that of D2 group(46.67%,P<0.05).After operation,the restlessness rate of D1 group was 6.67%,which was significantly lower than that of D2 group(26.67%).The restlessness score of D1 group was significantly lower than that of D2 group(P<0.05).Conclusion The combination of sevoflurane and nasal spray into dexmedetomidine can significantly reduce preoperative anxiety,no respiratory depression and easy separation from parents.At the same time,it can effectively prevent postoperative agitation in children.It is a safe and effective method for inducing pediatric anesthesia.