不同剂量右美托咪定预处理对小儿腹腔镜下腹股沟疝高位结扎术后行为的影响

Effects of different doses of dexmedetomidine pretreatment on behavior after laparoscopic high ligation of inguinal hernia in children

目的探究在小儿腹腔镜下腹股沟疝高位结扎术中应用不同剂量右美托咪定的效果,以了解该药物对患儿应激反应的影响。方法抽取2019年6月~2022年6月收治的100例行腹腔镜下疝气高位结扎术的腹股沟疝患儿作为研究对象,根据入院时间平均分为参照组和研究组,每组患者50例,参照组右美托咪定滴鼻剂量为0.5μg/kg。研究组右美托咪定滴鼻剂量为1.0μg/kg,对比两组不同时段麻醉效果、应激反应指标、麻醉质量及不良反应发生情况。结果两组患者T1~T4时刻SpO_(2)水平差异均无统计学意义(P>0.05);T1时刻组间HR值差异无统计学意义(P>0.05),T_(2)、T_(3)、T_(4)时刻研究组HR、MAP值均低于参照组相应值,并且研究组在T_(2)~T_(4)时HR、MAP均较参照组低,差异具有统计学意义(P<0.05);术前两组患者皮质醇、去甲肾上腺素水平差异无统计学意义(P>0.05),手术即刻两组患者的皮质醇、去甲肾上腺素水平升高,并且手术即刻研究组患者的以上指标水平低于参照组,差异均具有统计学意义(P<0.05);研究组患者的麻醉时间长于参照组,差异具有统计学意义(P<0.05);研究组患者苏醒即刻、苏醒后5 min、15 min RASS评分均低于参照组,差异均具有统计学意义(P<0.05);参照组不良反应发生率为24.00%,研究组不良反应发生率为6.00%,差异具有统计学意义(P<0.05)。结论1μg/kg右美托咪定对提高小儿腹腔镜下腹股沟疝高位结扎术麻醉效果,减轻患儿应激反应,改善术后行为,减少苏醒期躁动的发生有重要作用,相较于0.5μg/kg右美托咪定剂量,能够有效保障围术期的安全性。

Objective To explore the effect of different doses of dexmedetomidine in laparoscopic high ligation of inguinal hernia in children,so as to understand the impact of the drug on the stress response of children.Methods A total of 100 children with inguinal hernia who underwent laparoscopic high hernia ligation in our hospital from June 2019 to June 2022 were selected as the research objects of this article.In 50 cases,the nasal dose of dexmedetomidine in the reference group was 0.5μg/kg.The intranasal dose of dexmedetomidine in the study group was 1.0μg/kg,and the anesthesia effect,stress response index,anesthesia quality and occurrence of adverse reactions were compared between the two groups at different time periods.Results There was no significant difference in SpO_(2)levels between the two groups at T_(1)~T_(4)(P>0.05);There was no statistically significant difference in HR values between groups at T1 time(P>0.05).HR and MAP values of the study group at T_(2),T_(3)and T_(4)time were lower than the corresponding values of the reference group,and HR and map values of the study group at T_(2)~T_(4)time were lower than those of the reference group,the difference was statistically significant(P<0.05);There was no significant difference in the levels of cortisol and norepinephrine between the two groups before operation(P>0.05).The levels of cortisol and norepinephrine in the two groups increased immediately after operation,and the levels of the above indicators in the study group were lower than those in the reference group immediately after operation,and the differences were statistically significant(P<0.05);The anesthesia time of patients in the study group was longer than that in the reference group,and the difference was statistically significant(P<0.05);The RASS scores of patients in the study group were lower than those in the reference group immediately after awakening,5 minutes and 15 minutes after awakening,and the difference was statistically significant(P<0.05);The incidence of adverse reactions in the reference group was 24.00%,and that in the study group was 6.00%,and the difference was statistically significant(P<0.05).Conclusion 1μg/kg dexmedetomidine plays an important role in improving the anesthetic effect of laparoscopic high ligation of inguinal hernia in children,reducing the stress response of children,improving postoperative behavior,and reducing the occurrence of restlessness during awakening,compared with 0.5μg/kg dexmedetomidine dose can effectively ensure the safety of perioperative period.