右美托咪定滴鼻对小儿七氟烷麻醉术前焦虑和术后躁动的影响

Effect of intranasal dexmedetomidine on preoperative anxiety and postoperative agitation in children undergoing sevoflurane anesthesia

目的:探讨右美托咪定滴鼻对小儿七氟烷麻醉术前焦虑和术后躁动的影响。方法:收集2021年6月至2022年4月本院收治的腹股沟疝手术患儿68例,随机分为对照组和观察组,每组34例。两组术中均采用七氟烷麻醉,观察组术前给予右美托咪定滴鼻,对照组术前给予等量生理盐水滴鼻,30 min后进入手术室进行麻醉诱导。记录两组不同时点血流动力学指标、术前焦虑评分,比较两组患儿苏醒期躁动情况及疼痛评分,比较两组诱导时间与苏醒时间。结果:两组患儿术中血流动力学平稳,术中不同时点观察组心率(HR)及平均动脉压(MAP)均低于对照组(均P<0.05);两组术中不同时点脉搏血氧饱和度(SpO_(2))比较,差异均无统计学意义(均P>0.05)。观察组患儿行静脉穿刺时及麻醉诱导开始时的焦虑评分显著低于对照组(均P<0.05)。观察组不同时点躁动情绪评分及疼痛评分均低于对照组(均P<0.05)。观察组诱导时间较对照组更短(P<0.05),而两组苏醒时间差异无统计学意义(P>0.05)。结论:术前给予右美托咪定滴鼻可缓解患儿术前焦虑,降低七氟烷麻醉后苏醒期躁动,缩短七氟烷麻醉诱导时间同时未延长麻醉苏醒时间,且对患儿血流动力学的影响较小。

Objective:To investigate the effect of intranasal dexmedetomidine on preoperative anxiety and postoperative agitation in children undergoing sevoflurane anesthesia.Methods:A total of 68 children with inguinal hernia surgery admitted to our hospital from June 2021 to April 2022 were collected and randomly divided into control group and observation group,with 34 cases in each group.Sevoflurane anesthesia was used in both groups during the operation.Dexmedetomidine nasal dripping was performed in the observation group before operation,and the control group was given the same amount of normal saline nasal drops before operation,while the children entered the operating room for anesthesia induction after 30 min.The hemodynamic indexes and preoperative anxiety scores of the two groups at different time points were recorded.The restlessness and pain scores of the two groups were compared.The induction time and recovery time of the two groups were compared.Results:The hemodynamics of the two groups were stable during the operation,and the heart rate(HR)and mean arterial pressure(MAP)in the observation group were lower than those in the control group at different time points during operation(all P<0.05).There was no significant difference in pulse oxygen saturation(SpO_(2))between the two groups at different time points during operation(all P>0.05).The anxiety scores at the time of venipuncture and the beginning of anesthesia induction in the observation group were significantly lower than those in the control group(all P<0.05).The scores of agitation and pain in the observation group were lower than those in the control group at different time points(all P<0.05).The induction time of the observation group was shorter than that of the control group(P<0.05),and there was no significant difference in recovery time between the two groups(P>0.05).Conclusion:Preoperative intranasal administration of dexmedetomidine can relieve preoperative anxiety,reduce emergence agitation after sevoflurane anesthesia,shorten the induction time of sevoflurane anesthesia without prolonging the recovery time of anesthesia,and has little effect on hemodynamics in children.