不同剂量右美托咪定滴鼻在小儿腺样体切除术前应用效果的比较  

Effects of Intranasal Premedication of Different Doses of Dexmedetomidine in Pediatric Patients Undergoing Adenoidectomy

作　　者：陈璐璐[1] 熊琦[1] 陈沛[1] 王加芳 CHEN Lulu;XIONG Qi;CHEN Pei;WANG Jiafang(Department of Otolaryngology Head and Neck Surgery 1.Department of Anesthesiology;Wuhan No.1 Hospital Affiliated to Huazhong University of Science and Technology Tongji Medical College,Hubei Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属武汉市第一医院耳鼻咽喉头颈外科,湖北武汉430022 [2]华中科技大学同济医学院附属武汉市第一医院麻醉科,湖北武汉430022

出　　处：《中国医药导刊》2018年第5期275-278,共4页Chinese Journal of Medicinal Guide

摘　　要：目的:比较小儿腺样体切除术前应用不同剂量右美托咪定滴鼻的安全性和有效性。方法:选择择期行全麻下腺样体切除术患儿60例,ASA分级Ⅰ~Ⅱ级,随机分为3组:右美托咪定1μg·kg-1组(D1),右美托咪定2μg·kg-1组(D2),生理盐水组(NS),每组各20例。D1组经鼻滴入右美托咪定1μg·kg-1,D2组滴入右美托咪定2μg·kg-1,NS组滴入生理盐水0.5 m L。记录3组患儿滴鼻前(T1)及滴鼻后15 min(T2)、30 min(T3)、45min(T4)的心率(HR)、脉搏血氧饱和度(Sp O2);记录D1组和D2组患儿的入睡时间;记录滴鼻后45 min(T4)各组患儿的镇静评分、情绪评分与父母分离的抵抗评分。结果:与NS组比较,D2组患儿T3和T4时HR降低(P<0.05);与D1组比较,D2组患儿T4时HR降低(P<0.05);3组患儿各时点Sp O2的差异无统计学意义(P>0.05)。D2组的平均入睡时间为(26.5±5.7)min,明显短于D1组的(33.8±4.3)min(P<0.05)。D1组和D2组患儿的镇静评分和情绪评分明显高于NS组(P<0.05),D2组的父母分离抵抗评分高于NS组(P<0.05);与D1组比较,D2组患儿的镇静评分、情绪评分和父母分离的抵抗评分均增高(P<0.05)。结论:小儿腺样体切除术前经鼻滴入2μg·kg-1右美托咪定是安全有效的,可产生良好的镇静作用,可作为此类手术患儿术前用药的一种选择。Objective ： To observe the effect of different doses of dexmedetomidine preoperative intranasal medication in children adenoidectomy. Methods ： 60 children for adenoidectomy（ASA Ⅰ or Ⅱ） were randomly divided into three groups（ n= 20 each）： the D1,D2 and NS groups.Group D1 was given dexmedetomidine 1 μg·kg -1 , group D2 was given dexmedetomidine 2 μg·kg -1 and group NS was given normal saline 0.5 mL. HR and SpO 2 were monitored and recorded before intranasal medication（T1）, 15 min（T2）, 30 min（T3）, 45 min（T4） after intranasal medication. The children′s sleep latency was observed. At 45 minutes（T4） after medication, the scores of sedation, mood and behaviour at separation from parents were evaluated were recorded. Results ： HR in group D2 at T3 and T4 were lower than those in group NS（ P〈 0.05）. Compared with group D1,HR at T4 were lower in group D2（ P〈 0.05） .There were no significant differences（ P〉 0.05） in SpO 2 between the three groups. The children′s sleep latency in group D2 was （26.5±5.7）min,which was shorter than that in group D1 （33.8±4.3）min（ P〈 0.05）. The sedation scores and mood scores in group D1 and D2 were higher than those in group NS（ P〈 0.05）. The scores of behaviour at separation from parents in group D2 were better than those in group NS（ P〈 0.05）. Compared with group D1, the scores of sedation, mood and behaviour at separation from parents in group D2 were significantly higher （ P〈 0.05）. Conclusion ： Premedication with intranasal dexmedetomidine 2 μg·kg -1 in pediatric patients undergoing adenoidectomy is safe, and has good sedation effect, which may be used as a choice for children premedication.

关 键 词：右美托咪定 经鼻给药 术前用药 腺样体切除术 小儿 

分 类 号：R971.2[医药卫生—药品]