右美托咪定术前滴鼻对小儿疝气围术期舒适度的影响

The Effect of Dexmedetomidine Nasal Drip Before Operation on Perioperative Comfort of Hernia in Children

目的探讨右美托咪定术前滴鼻应用于小儿围术期安全性和可行性。方法选择60例择期行小儿单侧疝囊高位结扎患儿为研究对象,按随机数字表法分为右美托咪定组(观察组)和生理盐水组(对照组),每组30例,于麻醉前30 min观察组给予右美托咪定2μg/kg滴鼻,对照组经鼻腔滴入等量的生理盐水。记录给药30 min后,患儿与家人分离时的镇静评分、七氟醚诱导时面罩接受程度评分、患儿拔管时间、PACU停留时间、患儿入恢复室不同时间的躁动评分,观察有无恶心呕吐、鼻腔不适、呼吸抑制等不良反应。结果观察组用药后30 min镇静评分、面罩接受程度评分均高于对照组,差异有统计学意义(P<0.05)。两组患儿拔管时间和PACU停留时间差异无统计学意义(P>0.05),观察组患儿在入PACU后不同时间的躁动评分均低于对照组,差异有统计学意义(P<0.05)。两组患儿给药后均无恶心呕吐、鼻腔不适、呼吸抑制等不良反应。结论右美托咪定术前滴鼻应用于小儿可减轻患儿围术期躁动程度,未发现有明显的不良反应。

Objective To investigate the safety and feasibility of dexmedetomidine nasal drops in children.Methods Sixty children with unilateral hernia sac high ligation were selected as the study object.According to the random number table method,they were divided into the right metomidine group(observation group)and the normal saline group(control group).Each group had 30 cases.Thirty minutes before anesthesia,the observation group was given the right metomidine 2μg/kg nasal drip,and the control group was given the same amount of normal saline through the nasal cavity.After 30 minutes of administration,the sedation score,the mask acceptance score,the extubation time,the PACU stay time,and the restlessness score at different times when the child was in the recovery room were recorded,and the adverse reactions such as nausea and vomiting,nasal discomfort,and respiratory inhibition were observed.Results The scores of sedation and face mask acceptance in the observation group were higher than those in the control group(P<0.05).There was no significant difference in extubation time and PACU stay time between the two groups(P>0.05).The scores of restlessness in the observation group were lower than those in the control group at different time after PACU(P<0.05).There were no adverse reactions,such as nausea and vomiting,nasal discomfort,respiratory inhibition and so on.Conclusion The application of dexmedetomidine in children before operation can reduce the peri operation restlessness,no obvious adverse reactions were found.