术前右美托咪定滴鼻对扁桃体腺样体切除术患儿围术期的影响

Effect of intranasal dexmedetomidine for premedication on the occurrence of respiratory adverse events in children undergoing tonsill and adenoidectomy

目的探讨术前应用右美托咪定滴鼻对扁桃体腺样体切除术患儿围术期呼吸系统不良事件的影响。方法选取2020年10月—2021年6月徐州医科大学附属医院收治的择期扁桃体腺样体切除术的患儿120例,采用随机数字表法将患儿分为右美托咪定组(D组)和生理盐水组(N组),每组60例。D组在术前30 min经鼻给予右美托咪定2.0μg/kg(容量配置1 mL),N组术前30 min经鼻给予1 mL生理盐水。比较两组围术期呼吸系统不良事件发生率,镇静水平,术后疼痛评分,术后躁动谵妄水平,恶心、呕吐等其他不良事件。结果D组围术期呼吸系统不良事件发生率明显低于N组(P<0.05),且镇静水平高于N组(P<0.05),D组术后需求补救镇静的人数低于N组(P<0.05),D组苏醒期躁动发生率低于N组(P<0.05)。结论右美托咪定术前滴鼻可能与降低呼吸系统不良事件的发生率相关,并可取得较为满意的镇静效果,能减轻术后疼痛,降低苏醒期躁动的发生率。

Objective To investigate effect of intranasal dexmedetomidine vs placebo for premedication on the occurrence of respiratory adverse events in children undergoing tonsill and adenoidectomy.Methods A total of 120 children with elective tonsil adenectomy admitted to The Affiliated Hospital of Xuzhou Medical University from October 2020 to June 2021 were randomly divided into two groups,group D(n=60)received dexmedetomidine 2.0μg/kg and group N received saline 1mL at 30min before induction of anesthesia.The difference in the rate of occurrence of perioperative respiratory adverse events,the level of sedation,postoperative pain score,postoperative agitation and delirium,nausea,vomiting and other adverse events were compared between the two groups.Results The incidence of perioperative respiratory adverse events in group D was significantly lower than that of group N,and the level of sedation was higher than that of group N.The number of patients in group D requiring remedial sedation after surgery was lower than that of group N.The incidence of agitation during recovery in group D was lower than group N.Conclusion The intranasal dexmedetomidine may be associated with reducing the incidence of respiratory adverse events,and achieved a satisfactory sedative effect,reduced postoperative pain,and reduced the incidence of restlessness during recovery.