不同剂量右美托咪定滴鼻对婴幼儿心脏超声检查镇静效果与苏醒的影响

Effects of different doses of dexmedetomidine on the sedative effect and recovery in infants undergoing echocardiography

目的探讨经鼻给予右美托咪定(dexmedetomidine,Dex)2.5μg/kg与3.0μg/kg对患儿心脏彩色多普勒超声(彩超)检查镇静效果与苏醒的影响。方法行心脏彩超检查需要中深度镇静的患儿111例,年龄1~36个月,按随机数字表法分为2组:Dex 2.5μg/kg组(D1组,57例)和Dex 3.0μg/kg组(D2组,54例)。比较两组患儿的起效时间、总镇静时间、生命体征、镇静成功率、不良反应等,以年龄、体重、性别、禁食时间、起效时间为自变量,以总镇静时间为应变量,建立多重线性回归方程,探讨与苏醒有关的影响因素,选择更合理的临床镇静方案。结果两组患儿起效时间差异无统计学意义(P>0.05);总镇静时间D2组长于D1组,差异有统计学意义(P<0.05);镇静成功率和不良反应发生率比较差异无统计学意义(P>0.05)。多重线性回归分析显示,体重对总镇静时间产生显著的负向影响。分年龄比较显示,≤12个月的患儿总镇静时间长于12个月的患儿(P<0.05)。结论与3.0μg/kg Dex比较,2.5μg/kg Dex滴鼻不仅可以提供满意的镇静效果,且可以缩短在院时间。患儿的总镇静时间与体重呈负相关,年龄可作为给药剂量的参考,对于1岁以下的婴儿,应视所需镇静时长决定给药剂量。

Objective To compare the efficacy and safety of intranasal dexmedetomidine(Dex)between different doses of 2.5μg/kg and 3.0μg/kg in pediatric echocardiography sedation,and to explore the factors affecting recovery.Methods One hundred and eleven children,aged 1 to 36 months,were divided into 2 groups according to the random number table method:Dex 2.5μg/kg group received an intranasal dose of 2.5μg/kg Dex(D1 group,n=57)and Dex 3.0μg/kg group received an intranasal dose of 3.0μg/kg(D2 group,n=54).The induction time and total sedation time were compared.The success rate of sedation,the occurrence of any side effects with the drug and vital signs were also compared.Using age,sex,weight,fasting time and onset time as independent variables and total sedation time as dependent variables,the multiple linear regression analysis was performed to filtrate and formulate the valu‑able factors influencing recovery time Results There was no significant difference in induction time between D1 and D2 groups(P>0.05).The total sedation time in D2 group was significantly longer than the time in D1 group(P<0.05).There was no statistically signifi‑cant difference in sedation success rate and incidence of side effects between the two groups(P>0.05).Weight has a significant nega‑tive effect on total sedation time.The total sedation time at age≤12 months was longer than the time at age>12 months in both groups(P<0.05).Conclusions Compared with a dose of 3.0μg/kg given intranasally,a dose of 2.5μg/kg Dex can not only provide satisfacto‑ry sedation effect,but also shorten the length of hospital stay.The total sedation time was negatively correlated with weight.Age can be used as a reference for dosage.For infants under 1 year old,dosage should be determined according to the required length of sedation.