不同剂量盐酸右美托咪定在小儿扁桃体手术中抑制应激反应的效果观察

The Effect of different doses of dexmedetomidine hydrochloride on inhibiting stress response during pediatric tonsil surgery

目的探析不同剂量盐酸右美托咪定在小儿扁桃体手术中抑制应激反应的效果。方法选取2020年1月-2023年1月就诊于本院的小儿扁桃体手术患者研究,总纳入60例,依据随机数字法分组。A组给予右美托咪定(0.2μg/kg诱导剂量),B组给予右美托咪定(0.3μg/kg诱导剂量),C组给予右美托咪定(0.4μg/kg诱导剂量)。比较指标:应激指标、镇静疼痛程度、苏醒时间、护士满意度。结果①应激指标:插管时刻、手术开始时刻、拔管时刻,B组和C组的血压、心率明显低于A组(P<0.05);②镇静效果/疼痛程度:Ramsay镇静评分,B组和C组明显低于A组、C组明显低于B组;小儿哭闹例数B组和C组明显低于A组(P<0.05);③麻醉苏醒时间:苏醒时间和拔管所用时间,C组明显长于A组和B组(P<0.05);④病房护士满意度得分,B组和C组明显高于A组(P<0.05)。结论0.3μg/kg的盐酸右美托咪定产生的镇静镇痛效果更佳,明显提高小儿术后舒适度,对呼吸系统和循环系统的抑制不明显,中枢神经系统的镇静程度更符合病房护士的护理需求。

Objective To explore the effect of different doses of dexmedetomidine hydrochloride on inhibiting stress response during tonsil operation in children.Method A study was conducted on pediatric patients undergoing tonsil surgery who visited our hospital from January 2020 to January 2023.A total of 60 patients were included and randomly divided into groups.Group A was given dexmedetomidine(0.2μg/kg induction dose)and group B was given dexmedetomidine(0.3μg/kg induction dose).Group C was given dexmedetomidine(0.4μg/kg induction dose).Comparative indicators:stress indicators,degree of sedation and pain,awakening time,and nurse satisfaction.Result①Stress index:the blood pressure and heart rate of group B and C were significantly lower than those of group A at the time of intubation,the time of operation and the time of extubation(P<0.05);②Sedation effect/pain degree:Ramsay sedation score in groups B and C was significantly lower than that in group A and group C was significantly lower than that in group B,and the number of crying cases in groups B and C was significantly lower than that in group A(P<0.05);③Anesthesia recovery time:recovery time and extubation time in group C were significantly longer than those in groups A and B(P<0.05);④The satisfaction scores of ward nurses in groups B and C were significantly higher than those in group A(P<0.05).Conclusion 0.3μg/kg dexmedetomidine hydrochloride produced better sedative and analgesic effect,significantly improve the postoperative comfort of children,the suppression of respiratory system and circulatory system was not obvious,and the degree of sedation of central nervous system was more in line with the nursing needs of ward nurses.