不同剂量右美托咪定经鼻雾化用药在小儿术前镇静效果的比较  

Comparison of Sedative Effects of Two Spray Administration of Intranasal Dexmedetomidine Doses for Premedication in Children

作　　者：徐瑾[1] 邓晓明[1] 杨冬[1] 魏灵欣[1] 郅娟 徐文莉[1] 刘具会[1] DENG Xiao-ming YANG Dong WEI Ling-xin ZHI Juan XU Wen-li LIU Ju-hui(Department of Anesthesiology, Plastic Surgery Hospital, CAMS and PUMC, Beijing 100144, China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院麻醉科,北京100144

出　　处：《中国医学科学院学报》2016年第5期563-567,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的比较小儿术前经鼻雾化给予不同剂量右美托咪定（DEX）的镇静效果。方法择期全麻下行整形外科手术的患儿41例,ASA分级Ⅰ级,年龄3~6岁,随机分为DEX 1μg/kg组（D1组,n=21）和DEX 2μg/kg组（D2组,n=20）。经鼻雾化用药后每5 min评估患儿的镇静评分,并评估患儿入手术室前与父母的分离情况,观察用药后小儿心率（HR）和血氧饱和度（Sp O2）变化。结果 D1组和D2组患儿镇静起效时间分别为30 min和20 min;与父母分离的满意率分别为61.9%和95.0%,差异有统计学意义（χ~2=5.549,P=0.010）;D1组患儿用药后HR无明显变化（t=-0.299,P=0.767）,D2组患儿用药后30 min的HR较用药前下降了15.8%（t=2.415,P=0.021）;两组患儿用药后30 min的Sp O2变化差异均无统计学意义（t=-1.426,P=0.162;t=-1.096,P=0.280）。结论麻醉前30 min予患儿经鼻雾化喷入DEX 1μg/kg和2μg/kg,均可获得良好的镇静作用,其中DEX 2μg/kg起效更快,镇静效果更满意,患儿更易与父母分离。Objective To compare two spray administration of intranasal dexmedetomidine（ DEX） doses for premedication in children.Methods In this prospective,randomized,double-blind study,41 children aged 3-6 years were enrolled.Children were assigned to receive either spray administration of intranasal DEX1 μg/kg（ Group D1） or 2 μg/kg（ Group D2）.The Ramsay Sedation Scale scores were evaluated at 5 min intervals.Sedation status at separation from patient was also evaluated.Heart rate（ HR） and saturation of peripheral oxygen（ Sp O2） were recorded before and every 15 min after drug administration.Results The median sedation onset time was 30 min and 20 min in group D1 and group D2,respectively.Compared with the children in group D1,those in group D2 were significantly more sedated when they were separated from their parents（ 61.9% vs.95.0%,respectively）（ χ~2= 5.549,P = 0.010）.In Group D2,the HR decreased by 15.8%（ t =2.415,P = 0.021） 30 min after the spray administration of intranasal DEX.Compared with the baseline values,there was no significant difference in both groups in terms of Sp O2（ t =-1.426,P = 0.162; t =-1.096,P =0.280） and HR in group D1（ t =-0.299,P = 0.767） 30 min after the spray administration of intranasal DEX.Conclusion Spray administration of intranasal DEX 2 μg/kg provides superior sedation in children.

关 键 词：右美托咪定 经鼻雾化给药 小儿 术前镇静 

分 类 号：R614[医药卫生—麻醉学]