不同剂量右美托咪定经鼻雾化对小儿扁桃体腺样体切除术前镇静及术后苏醒质量的影响  

Effects of Different Doses of Dexmedetomidine Nasal Atomization on the Sedation before Tonsillectomy and the Quality of Recovery after Tonsillectomy in Children

作　　者：姬永久 时昌峰[1] JI Yongjiu;SHI Changfeng(Department of Anesthesiology,Huai′an First People′s Hospital Branch,Huai′an,Jiangsu Province,223001 China)

机构地区：[1]淮安市第一人民医院分院麻醉科,江苏淮安223001

出　　处：《世界复合医学》2022年第8期162-166,共5页World Journal of Complex Medicine

摘　　要：目的探讨不同剂量右美托咪定经鼻雾化对小儿扁桃体腺样体切除术前镇静及术后苏醒质量的影响。方法选取90例于2020年4—8月期间在淮安市第一人民医院分院接受扁桃体腺样体切除术治疗的患儿为研究对象,采用随机数表法分为4组。其中,麻醉诱导前给予1.0μg/kg右美托咪定(DEX)用药的患儿为观察1组,共23例;麻醉诱导前给予2.0μg/kg DEX用药的患儿为观察2组,共23例;麻醉诱导前给予2.5μg/kg DEX用药的患儿为观察3组,共22例;对照组仅在麻醉诱导前给予等量生理盐水雾化吸入,共22例。对比4组患儿术前镇静、术后苏醒质量以及用药安全性情况。结果不同剂量给药后,观察3组的镇静起效时间(12.44±2.12)min显著短于观察2组及观察1组,差异有统计学意义(F=2.728,P<0.05);观察3组的麻醉诱导时的镇静成功率(95.45%)显著高于观察2组以及观察1组,差异有统计学意义(χ^(2)=3.972,P<0.05);观察3组术后苏醒时PAED评分(4.00±0.50)分、CHIPPS评分(1.00±0.50)分以及苏醒15 minPAED评分(3.50±0.50)分、CHIPPS评分(1.00±0.50)分显著低于其他3组,差异有统计学意义(P<0.05);4组患儿治疗期间均无恶心、呕吐等不良反应发生。结论右美托咪定经鼻雾化在小儿扁桃体腺样体切除术中应用具有较佳的镇静效果,其中以2.5μg/kg DEX用药效果最佳,且用药安全性较高。Objective To investigate the effect of different doses of dexmedetomidine nasal atomization on the quality of sedation and recovery after tonsillectomy in children.Methods A total of 90 children who received tonsillectomy and adenoidectomy in Huai′an First People′s Hospital Branch from April 2020 to August 2020 were selected as the research objects,and they were divided into four groups by random number table method.Among them,the children who were given 1.0μg/kg dexmedetomidine(DEX)before induction of anesthesia were the observation group 1,with a total of 23 cases.The children who were given 2.0μg/kg DEX before induction of anesthesia were divided into observation group 2,with a total of 23 cases.Children who were given 2.5μg/kg DEX before induction of anesthesia were included in observation group 3,with a total of 22 cases.The control group was only given the same amount of normal saline inhalation before induction of anesthesia,with a total of 22 cases.The preoperative sedation,postoperative recovery quality and medication safety of the four groups were compared.Results After different doses,the sedation onset time of observation group 3(12.44±2.12)min was significantly shorter than observation group 2and observation group 1,and the difference was statistically significant(F=2.728,P<0.05).The success rate of sedation during induction of anesthesia in observation group 3(95.45%)was significantly higher than that in observation group 2 and observation group 1,and the difference was statistically significant(χ^(2)=3.972,P<0.05).The PAED score(4.00±0.50)points,CHIPPS score(1.00±0.50)points when waking up after surgery,and PAED score(3.50±0.50)points and CHIPPS score(1.00±0.50)points at 15 min after recovery in the observation group 3were significantly lower than those in the other three groups,the difference was statistically significant(P<0.05).No adverse reactions such as nausea and vomiting occurred in the four groups during treatment.Conclusion The application of dexmedetomidine through nasal aer

关 键 词：经鼻雾化 右美托咪定(DEX) 扁桃体腺样体切除术 术前镇静 术后苏醒质量 用药安全性 

分 类 号：R614[医药卫生—麻醉学]