咪达唑仑口服溶液比右美托咪定喷鼻更有效缓解儿童术前焦虑  

A comparative investigation of the impact of oral midazolam solution and dexmedetomidine nasal spray on preoperative anxiety in pediatric patients

作　　者：吴雄志 王宣 徐四七[1] 居霞[1] 王胜斌[1] 陈永权[2] WU Xiongzhi;WANG Xuan;XU Siqi;JU Xia;WANG Shengbin;CHEN Yongquan(Department of Anesthesiology,Anqing Municipal Hospital,Anqing 246003,Anhui,China;Department of Anesthesiology,Yijishan Hospital of Wannan Medical College,Wuhu 241002,Anhui,China)

机构地区：[1]安庆市立医院麻醉科,安徽安庆246003 [2]皖南医学院附属弋矶山医院麻醉科,安徽芜湖241002

出　　处：《中国临床药理学与治疗学》2023年第6期666-670,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：湖北陈孝平科技发展基金会临床研究基金(CXPJJHI2000005-07-44)。

摘　　要：目的:比较咪达唑仑口服溶液与右美托咪定喷鼻对儿童术前焦虑的影响。方法:选取2022年6~12月在我院拟行择期手术患儿90例,采用随机数字表法分为咪达唑仑口服溶液组、右美托咪定喷鼻组和生理盐水滴鼻组,麻醉前30 min,咪达唑仑口服溶液组0.5 mg/kg咪达唑仑口服溶液口服,右美托咪定喷鼻组2μg/kg右美托咪定喷鼻,生理盐水滴鼻组2 mL生理盐水滴鼻。记录3组患儿药物接受度。记录3组患儿给药前(T_(1))、与父母分开时(T_(2))、麻醉诱导时(T_(3))、术后24 h(T_(4))改良耶鲁术前焦虑量表(modified Yale preoperative anxiety scale‐short form,m-YPAS-SF)评分。记录3组患儿麻醉诱导时的麻醉诱导期合作度量表(induction compliance checklist,ICC)评分。记录3组患儿苏醒时间和PACU停留时间。结果:与右美托咪定喷鼻组和生理盐水滴鼻组比较,咪达唑仑口服溶液组药物接受度评分较低(P<0.05),T_(2)、T_(3)和T_(4)的m-YPAS-SF评分较低(P<0.05),ICC评分较低(P<0.05),苏醒时间较长(P<0.05),PACU停留时间无明显差异(P>0.05)。结论:咪达唑仑口服溶液比右美托咪啶喷鼻更易被患儿接受,更有效缓解术前焦虑,但苏醒时间较长。AIM:To investigate the impact of oral midazolam solution and dexmedetomidine nasal spray on preoperative anxiety in pediatric patients.METHODS:A total of 90 children who planned to receive elective surgery in our hospital from June to December 2022 were selected and divided into midazolam oral solution group,dexmedetomidine nasal spray group and normal saline nasal drops group by random number table method.Thirty minutes before anesthesia,midazolam oral solution 0.5 mg/kg was administered to midazolam oral solution group.Dexmedetomidine nasal spray group received 2μg/kg dexmedetomidine nasal spray and normal saline nasal drops group received 2 mL normal saline nasal drip.Drug acceptance was recorded in the three groups.modified Yale preoperative anxiety scale‐short form(m-YPAS-SF)score of the three groups of children were analyzed before administration(T_(1)),while separated from their parents(T_(2)),while during anesthesia induction(T_(3)),while 24 hours after surgery(T_(4)).The scores of induction Cooperation Scale(ICC)in induction of anesthesia were recorded in the three groups.The recovery time and PACU residence time of the three groups were recorded.RESULTS:Compared with dexmedetomidine nasal spray group and normal saline nasal drops group,midazolam oral solution group exhibited a lower drug acceptance score(P<0.05),as well as lower m-YPASSF scores at T_(2),T_(3),and T_(4)(P<0.05).Additionally,midazolam oral solution group had a lower ICC score(P<0.05)and longer recovery time(P<0.05),but no significant difference in the length of PACU stay was observed(P>0.05).CONCLUSION:Oral midazolam solution is more readily accepted by pediatric patients compared to dexmedetomidine nasal spray,and it exhibits superior efficacy in alleviating preoperative anxiety,however,its recovery time is prolonged.

关 键 词：咪达唑仑口服溶液 右美托咪定 术前焦虑 儿童 

分 类 号：R614[医药卫生—麻醉学]