右美托咪定与舒芬太尼鼻内给药用于儿童口腔科门诊手术镇静的临床观察  

Clinical Observation of Intranasal Dexmedetomidine and Sufentanil for Pediatric Sedation Undergoing Stomatology Operation of Outpatient Department

作　　者：储靖[1] 李宏[1] 蔡春妹 薛佩彤 霍金荣[1] 

机构地区：[1]武警后勤学院附属医院麻醉科,天津300162

出　　处：《中山大学学报（医学科学版）》2017年第3期438-442,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：武警后勤学院附属医院面上项目(FYM201550)

摘　　要：【目的】观察右美托咪定与的舒芬太尼鼻内给药用于儿童门诊手术的镇静效果。【方法】拟行口腔科门诊手术的患儿60例,年龄3~7岁,体质量10~32 kg,性别不限,ASA分级Ⅰ-Ⅱ级。采用随机数字表法,将患儿分为3组(n=20),右美托咪定联合舒芬太尼组(DS组),右美托咪定组(D组)和舒芬太尼组(S组),于术前准备室内分别经鼻予以右美托咪定2μg/kg和舒芬太尼1μg/kg;右美托咪定2μg/kg;舒芬太尼1μg/kg。记录入室时、术中、出室时和PACU中的俄亥俄州大学行为级别评分(OSUBRS)、密歇根州大学镇静评分(UMSS)。记录患儿用药前后的收缩压、心率和用药后不良反应。【结果】入室时和术中的OSUBRS评分DS组低于D组和S组(P<0.01);UMSS均高于D组和S组(P<0.05)。DS组的镇静成功率高于D组和S组(P<0.01)。DS组与D组用药后收缩压和心率下降的百分数无统计学差异(P>0.05)。没有患儿发生呼吸抑制、低血压和心动过缓。【结论】右美托咪定与舒芬太尼鼻内给药可为儿童口腔科门诊手术提供满意的镇静,并不伴有呼吸抑制、心动过缓和低血压的不良反应。[ Objective ] To research the sedative effect of intranasal dexmedetomidine and sufentanil for pediatric sedation for stomatological operation of outpatient department. [Methods] 60 children undergoing stomatological operation of outpatient depart- ment, age 3 - 7 years, weighing 10 - 32 kg, of ASA physical status Ⅰ -Ⅱ, were divided into the three groups （n = 20） randomly using a random number table： group dexmedetomidine and sufentanil （group DS） , group dexmetomidine （group D） , group sufentanil （group S）. Recorded the children＇s behavior using the Ohio State University behavior rating score （OSUBRS） , the University of Michigan Sedation Score （UMSS） , SBP, HR and side-effects when entry, during and leave operation and in post-anesthesia care unit, side-effects, the satisfaction of stomatological doctors and parents. [ Results ] The OSUBRS of group DS when entry, during operation were lower than group D （P 〈 0.01 ）. The UMSS of group DS were higher than group D and group S when entry and during operation （P 〈 0.05 ）. The success rate of group DS was higher than group D and group S （P 〈 0.01 ）. There was no different of mean percentage change in systolic blood pressure and heart rate from baseline between group DS and group D （P 〉 0.05）. There were no instances of respiratory depression, hypotension and bradycadia. [ Conclusion ] Intranasal dexmedetomidine and sufentanil provides satisfactory pediatric sedation for stomatological operation of outpatient department without side effects such as respiratory depression, bradycadia and hypotension.

关 键 词：右美托咪定 舒芬太尼 鼻内投药 口腔科手术 清醒镇静 

分 类 号：R452[医药卫生—治疗学]