右美托咪定喷鼻用于急诊小儿清创缝合的效果观察  

Observation on the sedative effect of intranasal dexmedetomidine used for children undergoing debridement suture surgery in department of emergency

作　　者：施保柱 石秀霞[1] 杨明华[1] 许再超[2] 季世强[3] 

机构地区：[1]河北省承德市中心医院重症医学科一病区,河北承德067000 [2]河北省承德市中心医院急诊科,河北承德067000 [3]河北省承德市中心医院普外科,河北承德067000

出　　处：《中国当代医药》2016年第2期103-105,共3页China Modern Medicine

摘　　要：目的观察右美托咪定用于急诊科小儿清创缝合术的镇静效果。方法选取2014年1月-2015年3月我院急诊科需清创缝合且难以配合的小儿40例,将其随机分为两组,每组20例,水合氯醛组（A组）和右美托咪定组（B组）。A组以10%水合氯醛0.5 ml/kg灌肠,B组以2μg/kg右美托咪定喷鼻,达镇到静效果后在2%利多卡因局部麻醉下行清创缝合术。监测比较两组患儿用药前后的心率（HR）、呼吸频率（RR）、末梢血氧饱和度（Sp O2）,观察镇静效果,进行Ramsay镇静评分,记录达到镇静所需时间及苏醒时间,并记录用药后患儿的不良反应。结果两组患儿用药后均能配合完成清创缝合术,B组镇静效果优于A组,清创缝合术后恢复所需时间短于A组,B组患儿无不良反应记录,A组患儿有1例出现恶心、呕吐不适。结论右美托咪定喷鼻用于急诊科小儿清创缝合术的镇静治疗效果确切,起效快、苏醒时间短,无明显不良反应,值得临床推广应用。Objective To observe the effect of intranasal dexmedetomidine used for children undergoing debridement suture surgery in department of emergency. Methods Forty children undergoing debridement suture surgery in department of emergency of our hospital from January 2014 to March 2015 were selected,and were randomly divided into two groups,20 cases in each group.The children in group A were treated with 10% chloral hydrate as enema（0.5 ml/kg）,while the group B were treated with intranasal dexmedetomidine（2 μg/kg）,debridement suture surgery undergoing with2% lidocaine after sedation.Heart rates,respiratory rates and oxyhemoglobin saturations before and after treatment between two groups were monitored and compared.The sedative effect between two groups was observed.Ramsay scores was obtained.The times to calm down and to wake up and the adverse reactions were recorded. Results The debridement suture surgery was completed between two groups after treatment.The sedative effect of group B was better than that of group A.The waking up time in group B was shorter than that of group A.No adverse reaction occured in group B,one child was found with nausea and vomiting in group A. Conclusion Intranasal dexmedetomidine used for children undergoing debridement suture surgery in department emergency has the advantages of taking action and recovery fast,good sedative effect and less incidence of adverse reactions than that with chloral hydrate,which is worth clinical popularizing and applying.

关 键 词：右美托咪定 急诊 小儿 镇静 清创缝合术 

分 类 号：R614.3[医药卫生—麻醉学]