右美托咪定经鼻预处理联合吸入麻醉在儿童角膜外伤手术中的麻醉、镇静效果及对术后苏醒期躁动的控制效果  

Anesthetic and sedative effects of dexmedetomidine nasal pretreatment combined with inhalation anesthesia in corneal trauma surgery in children and the control effect on postoperative agitation during recovery period

作　　者：苏云锋 杨潞培 惠永跃 Su Yunfeng;Yang Lupei;Hui Yongyue(Department of Anesthesiology,Nanyang Eye Hospital,Nanyang 473000,China)

机构地区：[1]南阳市眼科医院麻醉科,南阳473000

出　　处：《中国实用医刊》2023年第8期57-60,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析右美托咪定经鼻预处理联合吸入麻醉在儿童角膜外伤手术中的麻醉、镇静效果及对术后苏醒期躁动的控制效果。方法抽取2019年8月至2021年8月南阳市眼科医院接诊的儿童角膜外伤患儿65例,按照分段随机化分组法于术前将其分为参照组(32例)和观察组(33例),开展临床对照研究。所有患儿均接受眼科手术治疗,术中参照组给予吸入麻醉,观察组给予右美托咪定经鼻预处理+吸入麻醉。比较两组患儿心率、平均动脉压、血氧饱和度,统计并比较两组镇静评分、苏醒期躁动评分、躁动发生率、术后疼痛评分及术中麻醉相关不良反应发生率。结果观察组吸入麻醉即刻心率,及术后苏醒即刻心率、平均动脉压均低于参照组(t=2.47、5.25、0.29,P均<0.05)。观察组吸入麻醉即刻术中镇静评分高于参照组(t=3.73,P<0.05)。观察组Richmond躁动-镇静评分法评分、躁动发生率低于参照组,差异有统计学意义(t=9.43、5.63,P均<0.05)。患儿苏醒后15、30 min,观察组疼痛评分低于参照组(t=2.72、2.82,P均<0.05)。两组术中麻醉相关不良反应发生率比较,差异未见统计学意义(P=0.492)。结论儿童角膜外伤手术治疗中采用右美托咪定经鼻预处理联合吸入麻醉方案,可有效维持患儿围术期心率、平均动脉压稳定,优化术中镇静效果,降低麻醉苏醒期躁动风险,且未见明显麻醉不良反应,可保障患儿手术麻醉安全性。Objective To analyze the clinical anesthetic and sedative effects of dexmedetomidine nasal pretreatment combined with inhalation anesthesia in corneal trauma surgery in children,and its control effect on risk of emergency agitation.Methods A total of 65 children with corneal trauma treated in Nanyang Eye Hospital from August 2019 to August 2021 were selected,and the patients were divided into reference group(32 cases)and observation group(33 cases)according to the segmented randomized grouping method before operation.And the clinical controlled research was carried on.All children received ophthalmic surgery,the reference group was given inhalational anesthesia during the operation,and the observation group was given nasal pretreatment with dexmedetomidine combined with inhalational anesthesia.The heart rate,mean arterial pressure,and oxygen saturation were compared between the two groups.The sedation scores,recovery period agitation score,incidence of agitation,postoperative pain score and postoperative recovery time of the two groups were counted and compared.Results The heart rate immediately after inhalation anesthesia,postoperative heart rate and mean arterial pressure immediately after recovery in the observation group were lower than those in the reference group(t=2.47,5.25,0.29;all P<0.05).The intraoperative sedation score immediately after inhalation of the observation group was higher than that of the reference group(t=3.73,P<0.05).The Richmond agitation-sedation scale score and the incidence of agitation in the observation group were lower than those in the reference group,and the differences were statistically significant(t=9.43,5.63;all P<0.05).The pain scores of the observation group were lower than those of the reference group at 15 and 30 minutes after waking up(t=2.72,2.82;all P<0.05).There was no significant difference in the incidence of intraoperative anesthesia-related adverse reactions between the two groups(P=0.492).Conclusions The use of dexmedetomidine nasal pretreatment combined with inh

关 键 词：麻醉 右美托咪定经鼻预处理 吸入麻醉 儿童角膜外伤 

分 类 号：R726.1[医药卫生—儿科]