右美托咪定在腹股沟疝患儿手术中的麻醉效果和术后安全性分析

Anesthesia effect and postoperative safety analysis of dexmedetomidine in children with inguinal hernia surgery

目的探讨右美托咪定在腹股沟疝患儿手术中的麻醉效果和术后安全性。方法选取2020年10月—2021年3月金华市妇幼保健院收治的96例行腹股沟疝手术麻醉患儿为研究对象,根据随机数字表法将患儿分为观察组和对照组,每组各48例。两组患儿给予相同的麻醉诱导,对照组患儿在麻醉诱导前静脉泵入生理盐水,观察组患儿在诱导前静脉泵入稀释后的右美托咪定。对比两组患儿的麻醉效果,并评估其术前焦虑评分、术后苏醒期躁动情况、躁动发生率及术后疼痛评分,手术过程中记录不良反应,评估麻醉安全性。结果观察组患儿总有效率(95.83%)显著高于对照组(79.16%),差异有统计学意义(χ^(2)=6.095,P=0.014)。两组患儿改良耶鲁术前焦虑量表(mYPAS)和行为学疼痛评分法(FLACC)评分[对照组(12.13±4.38)分、(3.43±0.89)分,观察组(11.33±4.22)分、(3.02±1.02)分]比较,差异均无统计学意义(t=0.911、0.578,均P>0.05)。观察组患儿麻醉躁动量表(PAED)评分[(11.44±4.81)分]和躁动发生率(39.58%)均低于对照组[(6.15±2.55)分、6.25%],差异均有统计学意义(t=6.732,χ^(2)=15.098,均P<0.05)。观察组患儿不良反应发生率(16.66%)显著低于对照组(50.00%),差异有统计学意义(χ^(2)=12.000,P=0.014)。结论右美托咪定在腹股沟疝患儿手术中具有良好的麻醉效果,可减少患儿术后躁动发生率和不良反应,具有良好的安全性。

Objective To investigate the anesthesia effect and postoperative safety of dexmedetomidine in children with inguinal hernia surgery.Methods A total of 96 children who underwent inguinal hernia surgery anesthetized in Jinhua Maternal and child Health Care Hospital from October 2020 to March 2021 were selected.The patients were divided into observation group and control group according to the random number table method,with 48 in each group.The two groups were given the same induction of anesthesia.The control group was injected with normal saline before induction of anesthesia,and the observation group was injected with diluted dexmedetomidine before induction.The anesthesia effects of the two groups of children were compared,and their preoperative anxiety scores,postoperative restlessness during postoperative recovery,agitation incidence,and postoperative pain scores were evaluated.Adverse reactions were recorded during the operation to evaluate the safety of anesthesia.Results The total effective rate in the observation group(95.83%)was significantly higher than that in the control group(79.16%),and the difference was statistically significant(χ^(2)=6.095,P=0.014).There was no significant difference in MYPAS and FLACC scores between the two groups[control group(12.13±4.38)points,(3.43±0.89)points,observation group(11.33±4.22)points,(3.02±1.02)points](t=0.911,0.578,P>0.05).The PAED score[(11.44±4.81)points]and incidence of restlessness(39.58%)in the observation group were lower than those in the control group[(6.15±2.55)points,6.25%],and the difference was statistically significant(t=6.732,χ^(2)=15.098,all P<0.05).The incidence of adverse reactions in the observation group(16.66%)was significantly lower than that in the control group(50.00%),and the difference was statistically significant(χ^(2)=12.000,P=0.014).Conclusion Dexmedetomidine has a good anesthetic effect in the operation of children with inguinal hernia,can reduce the incidence of postoperative restlessness and adverse reactions in children,and has good safety.