右美托咪定经直肠或经鼻给药对扁桃体/腺样体切除术患儿术前镇静效果的对比研究  

Comparative study of the sedative effect of dexmedetomidine by rectum or intranasal administration on children before ade⁃notonsillectomy

作　　者：苏和升 姚嘉琦 吴悦 黄佳伟 熊苗苗 刘尧 季永[2] Su Hesheng;Yao Jiaqi;Wu Yue;Huang Jiawei;Xiong Miaomiao;Liu Yao;Ji Yong(School of Anesthesiology,Xuzhou Medical University,Xuzhou 221004,China;Department of Anesthesiology,the Affiliated Hospital ofJiangnan University,Wuxi 214122,China;Department of Pain Management,the Affiliated Hospital of Jiangnan University,Wuxi214122,China)

机构地区：[1]徐州医科大学麻醉学院,徐州221004 [2]江南大学附属医院麻醉科,无锡214122 [3]江南大学附属医院疼痛科,无锡214122

出　　处：《国际麻醉学与复苏杂志》2023年第7期710-714,共5页International Journal of Anesthesiology and Resuscitation

基　　金：无锡市卫健委科研项目(Q201908)。

摘　　要：目的比较右美托咪定(dexmedetomidine,Dex)经直肠给药或经鼻给药对扁桃体/腺样体切除术患儿术前镇静效果。方法择期行扁桃体/腺样体切除术患儿85例,按随机数字表法分为经直肠给药组(R组,43例)和经鼻给药组(N组,42例)。两组患儿均在术前45 min进入手术等候区,R组接受3μg/kg Dex直肠给药,N组接受3μg/kg Dex鼻内给药。记录两组患儿给药前(T_(0))、给药后5 min(T_(1))、给药后10 min(T_(2))、镇静起效时(T_(3))的心率、SpO_(2),记录两组患儿镇静效果[镇静起效时间、分离情绪满意率、静脉穿刺满意率、诱导依从性量表(induction compliance checklist,ICC)评分满意率],患儿给药满意率,家长满意度评分,麻醉苏醒情况(苏醒时间、出室时间、术后躁动发生率),给药至手术结束后2 h内心动过缓、低血压、低氧血症、恶心呕吐、喉痉挛等不良反应发生情况。结果与T_(0)比较,两组患儿T_(2)、T_(3)时心率降低(P<0.05);各时间点两组间心率、SpO_(2)差异无统计学意义(P>0.05)。R组患儿给药满意率、家长满意度评分高于N组(P<0.05)。两组患儿镇静起效时间、分离情绪满意率、静脉穿刺满意率、ICC评分满意率、苏醒时间、出室时间、术后躁动发生率差异无统计学意义(P>0.05)。所有患儿给药后至手术结束后2 h无心动过缓、低血压、低氧血症、恶心呕吐、喉痉挛等不良反应发生。结论Dex 3μg/kg经直肠给药可获得与经鼻给药相似的镇静效果,作为一种非侵入性镇静方式安全、有效,患儿接受度更高。Objective To compare the sedative effect of dexmedetomidine(Dex)by rectum administration or nasal administra⁃tion in children before adenotonsillectomy.Methods A total of 85 children who were scheduled for adenotonsillectomy were en⁃rolled.According to the random number table method,they were divided into two groups:a rectum administration group(group R,n=43)and a nasal administration group(group N,n=42).All children entered the operation waiting area 45 min before surgery.Children in group R were transrectally administered with Dex at 3μg/kg,while those in group N were nasally administered with Dex at 3μg/kg.Their heart rate and pulse oxygen saturation(SpO_(2))were recorded before administration(T_(0)),5 min(T_(1))and 10 min(T_(2))after administra⁃tion and at the onset of sedation(T_(3)).The sedative effects[the onset time of sedation,the satisfaction rate of separation emotion,the sat⁃isfaction rate of venipuncture and the satisfaction rate of induction compliance checklist(ICC)]were recorded.The satisfaction rate of medication in children,the score of parent satisfaction and awakening from anesthesia[the recovery time,the length of post⁃anesthesia care unit(PACU)stay and the rate of postoperative emergence agitation]were recorded.Furthermore,adverse events such as bradycar⁃dia,hypotension,hypoxemia,nausea and vomiting,and laryngeal spasms from the time of administration to 2 h after operation were re⁃corded.Results Compared with those at T_(0),both groups showed significant decreases in heart rate at T_(2) and T_(3)(P<0.05).There were no statistical differences in heart rate and SpO_(2) at each time point between the two groups(P>0.05).The satisfaction rate of medi⁃cation in children and the score of parent satisfaction in group R were significantly higher than those in group N(P<0.05).There were no statistical differences in the onset time of sedation,the satisfaction rate of separation emotion,the satisfaction rate of venipuncture and the satisfaction rate of ICC,the recovery time,the lengt

关 键 词：右美托咪定 镇静 直肠给药 经鼻给药 儿童 扁桃体/腺样体切除术 

分 类 号：R726.1[医药卫生—儿科]