右美托咪定滴鼻给药用于听力障碍儿童术前镇静的效果  

Preoperative sedation effects of intranasal dexmedetomidine in hearing disorder children

作　　者：戴庭辉 陈艳平[1] 阳星星 张燕玲[1] 曹德权[1] DAI Ting-hui;CHEN Yan-ping;YANG Xing-xing;ZHANG Yan-ling;CAO De-quan(Department of Anesthesiology,the Second Xiangya Hospital of Central South University,Changsha HU-NAN 410011,China)

机构地区：[1]中南大学湘雅二医院麻醉科,湖南长沙410011

出　　处：《中国新药与临床杂志》2021年第3期214-218,共5页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察不同剂量右美托咪定(Dex)滴鼻给药对听力障碍儿童术前镇静效果的影响。方法选择年龄6个月~6岁拟行人工耳蜗植入术患儿80例,随机均分为4组。D1、D2、D3组分别给予Dex 0.5、1.0、1.5μg·kg^(-1)滴鼻给药,对照组(C组)给予5%葡萄糖注射液0.2 mL。给药40 min后进入手术室,各组麻醉诱导和维持方式相同。记录术前、手术室等待区和术后24 h改良耶鲁围术期焦虑量表(m-YPAS)评分,以及术前亲子分离时镇静和行为状态评分,小儿苏醒期躁动(PAED)评分,监测患儿心率、血压和脉搏氧饱和度(SpO2)。结果D3组和D2组术前亲子分离时镇静和行为状态评分、PAED评分均低于D1组和C组(P<0.05),D3、D2、D1组术后24 h m-YPAS评分均较C组降低(P<0.05)。术前右美托咪定滴鼻给药后患儿心率、SpO2无明显变化,麻醉诱导后35 min内,D3、D2、D1组患儿心率较C组减慢(P<0.05)。围术期无缺氧、低血压、高血压、鼻腔刺激症状、过敏反应、术后恶心呕吐等不良反应发生。结论术前右美托咪定1.0μg·kg^(-1)滴鼻给药可为听力障碍儿童提供满意的术前镇静效果,且可有效缓解苏醒期的躁动和术后24 h的焦虑状态。AIM To observe the preoperative sedative effects of different dose of intranasal dexmedetomidine(Dex)in hearing disorder children.METHODS Eligible 80 hearing disorder children,aged 6 months to 6 years,scheduled for cochlear implantation,were enrolled.The children were randomly divided into 4 groups equally to receive intranasal dexmedetomidine 0.5μg·kg^(-1)(group D1),1.0μg·kg^(-1)(group D2),1.5μg·kg^(-1)(group D3),or 5%glucose solution 0.2 mL(group C).Forty minutes after administration,children entered the operation room.The induction and maintenance of anesthesia was in the same way in each group.The modified Yale preoperative anxiety scale(m-YPAS)score at operation waiting area,pre-and 24 h postoperative,the sedation and behavior status score at parent-child separation before surgery,the pediatric anesthesia emergence delirium(PAED)score,and the heart rate(HR),blood pressure(BP),and pulse oxygen saturation(SpO2)of the children were recorded.RESULTS Preoperative sedation and behavior status score and PAED score of the group D2 and D3 were significantly lower than those of the group D1 and group C(P<0.05).The m-YPAS score at 24 h postoperative in the group Dex was significantly lower compared with the group C(P<0.05).In the group Dex,there was no significant change in HR and SpO2 after administration.The HR in the group Dex was significantly lower than that in the group C within 35 min after anesthesia induced(P<0.05).There were no adverse reactions such as hypoxia,hypotension,hypertension,nasal irritation,anaphylaxis,postoperative nausea and vomiting occurred during perioperative period.CONCLUSION Intranasal dexmedetomidine 1.0μg·kg^(-1) could achieve satisfactory preoperative sedative effect and reduce the degree of emergence delirium and 24 h postoperative anxiety for hearing disorder children.

关 键 词：右美托咪定 投药 鼻内 听力障碍 儿童 术前镇静 

分 类 号：R971[医药卫生—药品]