术前镇静治疗在小儿短小手术的效果观察

Observation on the effect of preoperative sedation in children with short operation

目的:比较三种不同术前镇静治疗方法在小儿短小手术中的临床效果。方法:选取2019-2020年儿外科短小手术患儿120例,随机分为三组,各40例。A组术前给予鲁米那5 mg/kg肌肉注射;M组术前给予咪达唑仑0.5 mg/kg口服;D组术前给予右美托咪定3μg/kg滴鼻。比较三组临床效果。结果:M组药物接受满意度评分高于D组与A组,差异有统计学意义(P<0.05)。D组患儿的亲子分离评分低于A组与M组,差异有统计学意义(P<0.01)。给药后10~30 min,D组HR水平低于A组与M组,差异有统计学意义(P<0.01)。结论:咪达唑仑口服及右美托咪定滴鼻患儿更易于接受,且能预防苏醒期的躁动,均可作为小儿术前镇静的选择;右美托咪定滴鼻镇静效果好,亲子分离佳,临床实际应用效果更佳;但右美托咪定滴鼻入室镇静治疗需进一步的观察研究及改进。

Objective:To compare the clinical effect of three different methods of preoperative sedation in children with short operation.Methods:From 2019 to 2020,120 children with short and minor operations in pediatric surgery were selected and randomly divided into three groups with 40 cases in each group.Group A was given lumina 5 mg/kg intramuscular injection before operation.Group M was given midazolam 0.5 mg/kg oral administration before operation.Group D was given dexmedetomidine 3μg/kg nose drops before operation.We compared the clinical effects of the three groups.Results:In group M,the drug acceptance satisfaction score was higher than that in group D and group A,the difference was statistically significant(P<0.05).The parentage separation score of group D was lower than that of group A and group M,the difference was statistically significant(P<0.01).The HR level of group D was lower than that of group A and group M at 10~30 min after administration,the difference was statistically significant(P<0.01).Conclusion:Children are more likely to receive oral midazolam and nasal dexmedetomidine,and they can prevent agitation during recovery period,all of them can be used as the choice of preoperative sedation in children.The sedative effect of dexmedetomidine nasal drops is good,the parent-child separation is good,the clinical application effect is better.But dexmedetomidine intranasal sedation needs further observation and improvement.