右美托咪定对咽喉部手术鼾症儿童术后躁动及血流动力学的影响  

Effect of dexmedetomidine on postoperative agitation and hemodynamics of patients with snoring after throat surgery

作　　者：张红伟[1] 王卫卫 李晓芳[1] 樊腾[1] 张永强[1] 张江峰[1] 陈胜阳[1] 杨明月 岳修勤[1] ZHANG Hongwei;WAGN Weiwei;LI Xiaofang;FAN Teng;ZHANG Yongqiang;ZHANG Jiangfeng;CHEN Shengyang;YANG Mingyue;YUE Xiuqin(Department of Anesthesiology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院麻醉科,河南卫辉453100

出　　处：《新乡医学院学报》2021年第8期730-733,共4页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划省部共建项目(编号:SBGJ2018054);新乡医学院第一附属医院青年培育基金项目(编号:ON-2020-A03)。

摘　　要：目的探讨术前右美托咪定滴鼻对咽喉部手术鼾症儿童术后躁动及血流动力学的影响。方法选择2019年1月至2019年9月于新乡医学院第一附属医院行咽喉部手术的62例鼾症儿童为研究对象,采用随机数字表法将患儿分为观察组和对照组,每组31例。麻醉诱导前30 min,观察组患儿给予1μg·kg^(-1)右美托咪定(8μg·mL^(-1))滴鼻,对照组患儿给予等量生理盐水滴鼻。拔管后10 min,采用脸谱法评估患儿疼痛程度,小儿麻醉苏醒期躁动量化评分表评估患儿躁动情况;比较2组患儿麻醉开始时(T_(0))、手术开始时(T_(1))、拔管时(T_(2))的心率(HR)、平均动脉压(MAP)和经皮动脉血氧饱和度(SpO_(2))以及拔管时间、麻醉复苏室观察时间和术后不良反应。结果观察组患儿术后躁动评分和疼痛评分显著低于对照组(P<0.05)。2组患儿术后拔管时间、麻醉复苏室观察时间比较差异无统计学意义(P>0.05)。2组患儿T_(0)时HR、MAP显著低于T_(1)、T_(2)时(P<0.05);2组患儿T_(1)时HR、MAP与T_(2)时比较差异无统计学意义(P>0.05);T_(0)、T_(1)、T_(2)时,观察组患儿HR、MAP显著低于对照组(P<0.05);2组患儿各时间点SpO_(2)比较差异均无统计学意义(P>0.05)。对照组患儿发生鼻咽出血1例,恶心6例;观察组患儿未发现明显不良反应。结论术前右美托咪定滴鼻可降低儿童咽喉部手术术后躁动率和疼痛,维持血流动力学稳定,无明显不良反应。Objective To investigate the effect of dexmedetomidine by nasal dropping before surgery on postoperative restlessness and hemodynamics of children with snoring after throat surgery.Methods A total of 62 children with snoring underwent throat surgery in the First Affiliated Hospital of Xinxiang Medical University from January 2019 to September 2019 were selected as research subjects,and they were divided into the observation group and control group according to random number table,with 31 cases in each group.Thirty minutes before induction of anesthesia,the children in the observation group were given 1μg·kg^(-1)dexmedetomidine(8μg·mL^(-1))by nasal dropping,the children in the control group were given the same amount of normal saline by nasal dropping.Ten minutes after extubation,the pain degree of patients was evaluated by facebook method,the pediatric anesthesia emergence delirium scale was used to evaluate the agitation of patients.The heart rate(HR),mean arterial pressure(MAP),percutaneous arterial oxygen saturation(SpO_(2))at the beginning of anesthesia(T_(0)),beginning of operation(T_(1))and time of extubation(T_(2))were compared between the two groups,the time of extubation and the time of observation in postanesthesia care unit(PACU),and postoperative adverse reactions between the two groups were compared.Results The postoperative restlessness score and pain score of the children in the observation group were significantly lower than those in the control group(P<0.05),there was no statistically significant difference in the time of extubation and time of observation in PACU between the two groups(P>0.05).At T_(0),the HR and MAP were significantly lower than those at T_(1) and T_(2) in the two groups(P<0.05),there was no significant difference in HR and MAP at T_(1) and T_(2) in the two groups(P>0.05),the HR and MAP of children in the observation group was significantly lower than those in the control group at T_(0),T_(1) and T_(2)(P<0.05),there was no significant difference in SpO 2 between the two gro

关 键 词：右美托咪定 咽喉部手术 血流动力学 术后躁动 

分 类 号：R726.1[医药卫生—儿科]