右美托咪定经鼻滴入用于预防儿童人工耳蜗植入术苏醒期躁动的临床观察  

The efficacy and safety of intranasal dexmedetomidine on preventing pediatric emergence agitation after cochlear implant surgery

作　　者：金笛 肖玮[1] 王天龙[1] Jin Di;Wei Xiao;Wang Tianlong(Department of Anesthesiology and Operating Theater, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院麻醉手术科

出　　处：《北京医学》2019年第8期697-699,704,共4页Beijing Medical Journal

摘　　要：目的研究右美托咪定经鼻滴入用于预防儿童人工耳蜗植入术苏醒期躁动(emergence agitation, EA)的有效性及安全性。方法选取2018年1~12月首都医科大学宣武医院行单侧人工耳蜗植入术的10岁以下患儿48例,随机分为右美托咪定滴鼻组(实验组)及生理盐水滴鼻组(对照组),每组24例。记录两组拔除气管导管后5 min、15 min及30min儿童麻醉苏醒期谵妄(pediatric anesthesia emergence delirium, PAED)评分,拔管时间以及其他不良反应发生率。结果实验组及对照组EA发生率分别为8.3%(2/24)及33.3%(8/24),实验组拔管后5 min及15 min的PAED评分低于对照组,差异有统计学意义(P <0.05)。实验组拔管时间较对照组长[(11.96±7.14)min比(7.29±2.98)min,P <0.05]。两组术后恶心呕吐(postoperative nausea and vomiting, PONV)发生率比较,差异无统计学意义(P>0.05)。两组均未发生其他不良反应。结论右美托咪定经鼻滴入是预防儿童人工耳蜗植入术苏醒期躁动安全有效的方法,但可能延长患儿术后苏醒及拔管时间。Objective To study the efficacy and safety of intranasal dexmedetomidine on preventing pediatric emergence agitation after cochlear implant surgery. Methods Forty-eight children under 10 years old undergoing single side cochlear implant surgery from January to December 2018 were randomly divided into intranasal dexmedetomidine group(treatment group, n = 24) and intranasal saline group(control group, n = 24). The pediatric anesthesia emergence delirium(PAED)score at 5, 15, 30 min after extubation, time to extubate, and other adverse events were recorded. Results The incidence of emergence agitation in treatment group and control group were 8.3%(2/24) and 33.3%(8/24) respectively, PAED score at 5 min and 15 min after extubation in treatment group were lower than those in control group(P < 0.05). Time to extubate in treatment group was longer than that in control group [(11.96±7.14)min vs.(7.29±2.98)min, P < 0.05]. There was no significant difference in the postoperative nausea and vomiting(PONV) between the two groups(P > 0.05). There were no other adverse events in both groups. Conclusions Intranasal dexmedetomidine is an effective and safe approach to prevent pediatric emergence agitation after cochlear implant surgery, but it may prolong the recovery time and extubation time after operation.

关 键 词：右美托咪定 苏醒期躁动 人工耳蜗植入术 儿童 

分 类 号：R726.1[医药卫生—儿科]