不同剂量右美托咪定术前给药在鼻内镜下腺样体切除术患儿中的疗效及安全性  

Efficacy and Safety of Preoperative Administration of Different Doses of Dexmedetomidine in Children Undergoing Nasal Endoscope-Assisted Transoral Adenoidectomy

作　　者：杨鸿源[1] 尹静 李媛媛[1] 李昆鹏[2] 赵元奎[2] 白耀武[1] Yang Hongyuan;Yin Jing;Li Yuanyuan;Li Kunpeng;Zhao Yuankui;Bai Yaowu(Tangshan Maternal and Child Health Care Hospital,Hebei Tangshan 063000,China;The Second People's Hospital of Fengrun District,Hebei Tangshan 063000,China)

机构地区：[1]唐山市妇幼保健院,河北唐山063000 [2]唐山市丰润区第二人民医院,河北唐山063000

出　　处：《儿科药学杂志》2022年第4期37-41,共5页Journal of Pediatric Pharmacy

摘　　要：目的:探讨不同剂量右美托咪定(Dex)术前给药在鼻内镜下腺样体切除术患儿中的疗效及安全性。方法:选取2019年1月至2020年6月于唐山市妇幼保健院行腺样体切除术的120例患儿为研究对象,按随机数表法分为三组各40例。入室前60 min给予不同剂量的Dex滴鼻,A组剂量1μg/kg, B组剂量2μg/kg, C组剂量3μg/kg,比较三组患儿滴鼻前(T0)及滴鼻10 min(T1)、30 min(T2)、60 min(T3)时血流动力学指标,包括心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2)),术前镇静效果(镇静起效时间、镇静评分、分离抵抗评分、建立静脉通路行为学反应评分),术后麻醉苏醒时间(呼吸恢复时间、拔管时间、苏醒时间、定向力恢复时间)及术后不良反应。结果:HR、MAP、SpO_(2)组间、各时间点间、组间×时间点比较,差异均无统计学意义(P>0.05);三组镇静起效时间、镇静评分、分离抵抗评分、建立静脉通路行为学反应评分比较差异均有统计学意义(F值分别为30.18、10.37、9.18、23.05,P<0.05);三组术后呼吸恢复时间、拔管时间比较差异均无统计学意义(P>0.05),苏醒时间、定向力恢复时间比较差异均有统计学意义(F值分别为3.85、29.41,P<0.05);A组不良反应总发生率5.00%,B组7.50%,C组12.50%,组间比较差异无统计学意义(P>0.05)。结论:小儿鼻内镜下腺样体切除术术前经鼻滴入2μg/kg Dex是相对安全有效的,可产生较好的镇静效果,且术后不良反应较少,可作为该类小儿手术术前麻醉的推荐剂量。Objective: To probe into the efficacy and safety of preoperative administration of different doses of dexmedetomidine(Dex) in children undergoing nasal endoscope-assisted transoral adenoidectomy. Methods: A total of 120 children undergoing adenoidectomy in Tangshan Maternal and Child Health Care Hospital from Jan. 2019 to Jun. 2020 were extracted to be divided into three groups via the random number table, with 30 cases in each group. Different doses of Dex nasal drops were given 60 minutes before entering the room, the doses of group A, group B and group C were respectively 1 μg/kg, 2 μg/kg and 3 μg/kg. The hemodynamic indicators of three groups were compared before nasal drip(T0) and at 10 min(T1), 30 min(T2) and 60 min(T3) of nasal drip, including heart rate(HR), mean arterial pressure(MAP), blood oxygen saturation(SpO_(2)), preoperative sedation effects(sedation onset time, sedation score, separation resistance score, behavioral response score of venous access establishment), recovery time of postoperative anesthesia(recovery time of respiration, extubation time, awakening time, recovery time of orientation) and postoperative adverse drug reactions. Results: There were no statistically significant differences in the between-group effect, time-point effect and interaction effect of between-group×time-point of HR, MAP and SpO_(2)(P>0.05). There were statistically significant differences in the sedation onset time, sedation score, separation resistance score and behavioral response score of venous access establishment among three groups(F=30.18, 10.37, 9.18, 23.05, P<0.05). The difference was not statistically significant in recovery time of respiration and extubation time among three groups(P>0.05). And there were statistical differences in awakening time and recovery time of orientation(F=3.85, 29.41, P<0.05). The total incidences of adverse drug reactions were respectively 5.00% in group A, 7.50% in group B and 12.50% in group C, with no statistically significant difference(P>0.05). Conclusion: Nasal drop

关 键 词：右美托咪定 腺样体切除术 血流动力学 镇静效果 苏醒期躁动 

分 类 号：R726.1[医药卫生—儿科]