艾司氯胺酮联合右美托咪定滴鼻在小儿眼科检查中的镇静效果比较

Comparison of Sedation of Esketamine Combined with Dexmedetomidine Intranasal in Pediatric Ophthalmic Examination

目的:比较不同剂量艾司氯胺酮联合右美托咪定滴鼻在小儿眼科检查中的镇静效果。方法:选取2020年6月至2021年10月在本院门诊或住院做眼科检查前需镇静的婴幼儿120例,采用随机数字表法,将患儿分为3组:D组:右美托咪定2 μg/kg;S1 + D组:艾司氯胺酮0.25 μg/kg + 右美托咪定2 μg/kg;S2 + D组:艾司氯胺酮0.5 μg/kg + 右美托咪定2 μg/kg滴鼻。统计分析不同组别的滴鼻首次成功率、镇静起效时间、镇静复苏时间以及不良反应等数据。结果:S1 + D组及S2 + D组在滴鼻首次成功率、镇静起效时间方面显著高于单独使用右美托咪定组,且具有统计学意义(P 【0.05),且S1 + D组在镇静复苏时间较S2 + D组显著缩短,不良反应方面无统计学意义。结论:艾司氯胺酮0.25 μg/kg联合右美托咪定2 μg/kg滴鼻在小儿眼科检查中镇静效果满意,且复苏时间短,是一种安全有效的镇静方法。

Objective: To compare the sedative effect of different doses of esketamine combined with dexmedetomidine intranasals in pediatric ophthalmic examination. Methods: A total of 120 infants who needed sedation before ophthalmic examination in outpatient department or inpatient department of our hospital from June 2020 to October 2021 were selected and divided into 3 groups by random number table method: Group D: Dexmedetomidine 2 μg/kg;group S1 + D: Esketamine 0.25 μg/kg + dexmedetomidine 2 μg/kg;S2 + D group: Esketamine 0.5 μg/kg + dexmedetomidine 2 μg/kg intranasals. The data of first success rate of intranasal, effective time of sedation, recovery time of sedation and adverse reactions in different groups were analyzed. Results: The first success rate of intranasal and the sedation onset time in S1 + D and S2 + D groups were significantly higher than those in dexmedetomidine alone, with statistical significance (P <0.05), and the sedation recovery time in S1 + D group was significantly shorter than that in S2 + D group, and there was no statistical significance in adverse reactions. Conclusion: Esketamine 0.25 μg/kg combined with dexmedetomidine 2 μg/kg intranasals has satisfactory sedation effect in pediatric ophthalmic examination, and the time of resuscitation is short. It is a safe and effective sedation method.