鼻喷右美托咪定在儿童牙科患者术前镇静中的应用  

Application of dexmedetomidine nasal spray in preoperative sedation of pediatric dental patients

作　　者：叶嘉良 王志林 王娜 陈洁虹 陈玉婷 YE Jialiang;WANG Zhilin;WANG Na;CHEN Jiehong;CHEN Yuting(Department of Anesthesiology,Stomatological Hospital Affiliated to Foshan University of Science and Technology,Foshan Stomatological Hospital,Guangdong,Foshan 528000,China;Department of Prosthodontics,Stomatological Hospital Affiliated to Foshan University of Science and Technology,Foshan Stomatological Hospital,Guangdong,Foshan 528000,China;Department of Pediatric Stomatology,Stomatological Hospital Affiliated to Foshan University of Science and Technology,Foshan Stomatological Hospital,Guangdong,Foshan 528000,China;Department of Oral and Maxillofacial Surgery,Stomatological Hospital Affiliated to Foshan University of Science and Technology,Foshan Stomatological Hospital,Guangdong,Foshan 528000,China)

机构地区：[1]佛山科学技术学院附属口腔医院,广东省佛山市口腔医院麻醉科,广东佛山528000 [2]佛山科学技术学院附属口腔医院,广东省佛山市口腔医院修复科,广东佛山528000 [3]佛山科学技术学院附属口腔医院,广东省佛山市口腔医院儿童口腔科,广东佛山528000 [4]佛山科学技术学院附属口腔医院,广东省佛山市口腔医院口腔颌面外科,广东佛山528000

出　　处：《中国医药科学》2021年第19期162-166,共5页China Medicine And Pharmacy

基　　金：广东省佛山市卫生健康局医学科研课题立项(20210227)。

摘　　要：目的观察鼻喷右美托咪定运用于儿童牙科患者术前镇静的效果。方法回顾性分析2019年10月至2020年10月于佛山市口腔医院儿童牙科门诊收治的行全身麻醉下牙病治疗的患儿120例,根据麻醉方式不同分为对照组(n=42)、观察A组(n=36)及观察B组(n=42),对照组予静脉泵注右美托咪定1μg/kg,观察A组给予鼻喷右美托咪定1μg/kg,观察B组给予鼻喷右美托咪定2μg/kg。比较三组患儿HR、SpO_(2)、Ramsay镇静评分、手术时间、拔管时间、苏醒时间、分离焦虑评分、儿童麻醉诱导合作评分以及不良反应发生率。结果三组患儿在给药前、给药后15、30 min的HR、SpO_(2)均处于正常范围内。三组在给药前的HR比较差异无统计学意义(P>0.05);对照组、观察B组在给药后15 min的HR下降幅度大于观察A组,且与观察A组比较差异均有统计学意义(P<0.05);三组在给药后30 min的HR水平比较差异均无统计学意义(P>0.05);各组在给药后15、30 min的HR水平比较差异有统计学意义(P<0.05)。三组在给药前的SpO_(2)比较差异无统计学意义(P>0.05);对照组、观察B组在给药后15 min的SpO_(2)下降幅度大于观察A组,差异均有统计学意义(P<0.05);三组在给药后30 min的SpO_(2)水平比较差异均无统计学意义(P>0.05)。三组患儿在给药前Ramsay镇静评分比较差异无统计学意义(P>0.05),给药后15 min,三组患儿的镇静评分均上升,但三组间比较差异无统计学意义(P>0.05),给药后30 min,三组患儿的镇静评分均下降,但三组间比较差异无统计学意义(P>0.05)。三组患儿手术时间、拔管时间及苏醒时间比较差异无统计学意义(P>0.05)。三组的不良反应发生率比较差异无统计学意义(P>0.05)。结论鼻喷右美托咪定在儿童牙科患者术前镇静中有较好的运用效果,对儿童的心率、手术时间、拔管时间及苏醒时间影响小,也可以较好地缓解患儿治疗中的分离焦虑。Objective To observe the effect of dexmedetomidine nasal spray in preoperative sedation of pediatric dental patients.Methods A total of 120 children admitted to the pediatric dental clinic undergoing dental treatment under general anesthesia in Foshan Stomatological Hospital from October 2019 to October 2020 were retrospectively analyzed and divided into the control group(n=42),the observation group A(n=36)and the obs ervation group B(n=42)according to the different anesthetic methods.The control group was given dexmedetomidine 1μg/kg by intravenous pump.The observation A group was given dexmedetomidine 1μg/kg by nasal spray,and the observation B group was given dexmedetomidine 2μg/kg by nasal spray.The HR,SpO_(2),Ramsay sedation scores,operation time,extubation time and recovery time,separation anxiety scores,compliance scores during anesthesia induction in children and incidence of adverse reactions were compared among the three groups of children.Results The HR and SpO_(2) of the children in the three groups were within the normal range before drug administration and at 15 and 30 min after the administration.There was no statistically significant difference in terms of HR levels before drug administration among the three groups(P>0.05).The decrease in HR levels in the control group and the observation B group at 15 min after drug administration was greater than that in the observation A group,with statistically significant difference(P<0.05).There was no statistically significant difference in terms of HR levels at 30 min after drug administration among the three groups(P>0.05).There was a statistically significant difference in terms of HR level at 15 min and 30 min after drug administration in each group(P<0.05).There was no statistically significant difference in terms of SpO_(2) levels before drug administration among the three groups(P>0.05).The decrease in SpO_(2) levels at 15 min after drug administration in the control group and the observation B group was greater than that in the observation A grou

关 键 词：鼻喷 右美托咪定 儿童 术前镇静 

分 类 号：R782.054[医药卫生—口腔医学]