全麻下儿童角膜外伤检查治疗前右美托咪定滴鼻预处理的效果

The efficacy of intranasal dexmedetomidine premedication before examination and treatment of corneal trauma in children under general anaesthesia

目的评价右美托咪定滴鼻预处理在全麻下儿童角膜外伤检查治疗前应用的效果。方法前瞻性病例对照研究。郑州大学第一附属医院2018年3月至2020年8月行全麻下角膜外伤检查治疗的患儿60例,按随机数字表法分为右美托咪定滴鼻联合七氟醚吸入麻醉组(DS组)和单纯七氟醚吸入麻醉组(S组),各30例。比较两组术中及术后各项指标。结果DS组的镇静、情绪、与父母分离时和对面罩接受情况的评分均显著优于S组(P<0.05)。患儿滴鼻前,滴鼻后30 min,七氟醚诱导麻醉后和苏醒时,两组的心率和血氧饱和度差异无统计学意义(P>0.05)。DS组的苏醒期躁动者2例(6.67%)明显少于S组的11例(36.67%)(χ^(2)=7.954,P=0.005),而苏醒时间差异无统计学意义(t=1.265,P=0.211)。结论角膜外伤患儿全麻下检查治疗前使用右美托咪定滴鼻预处理可以提升患儿的全麻配合度,并降低术后躁动的发生。

Objective To evaluate the efficacy of application of intranasal dexmedetomidine premedication before examination and treatment of pediatric corneal trauma in children under general anesthesia.Methods This was a prospective case control study.Total of 60 children with corneal trauma from Mar.2018 to Aug.2020 in the First Affiliated Hospital of Zhengzhou University who received examination and treatment under general anesthesia were divided into two groups based on random number table methods.There were 30 cases received dexmedetomidine nasal drip combined with sevoflurane inhalation anesthesia as DS group,and the other 30 cases received simple sevoflurane inhalation anesthesia as S group.The intraoperative and postoperative conditions between the two groups were compared.Results The scores of sedation,emotion condition,separation condition from parents and acceptance of face mask in DS group were significantly superior to those in S group(P<0.05).Before nasal drip,30 minutes after nasal drip,after sevoflurane induction anesthesia and at the time of awakening,there was no significant difference in heart rate or blood oxygen saturation between the two groups(P>0.05).The emergence agitation children of DS group in 2 cases(6.67%)was significantly less than that of S group in 11 cases(36.67%)(χ^(2)=7.954,P=0.005),and there was no significant difference in the recovery time(t=1.265,P=0.211).Conclusion Intranasal dexmedetomidine premedication in children with corneal trauma before examination and treatment under general anaesthesia can improve the coordination of general anesthesia and reduce the incidence of postoperative agitation.