口服咪达唑仑与右美托咪定滴鼻应用于小儿斜视矫正术前镇静效果分析  

Analysis on preoperative sedative effect of oral midazolam versus dexmedetomidine nasal drip during pediatric strabotomy

作　　者：张婉月 何士凤 汤西玲 候雅欣 孙振涛[1] ZHANG Wanyue;HE Shifeng;TANG Xiling;HOU Yaxin;SUN Zhentao(Department of Anesthesiology and Perioperative Medicine,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,郑州450052

出　　处：《重庆医学》2023年第22期3434-3437,3442,共5页Chongqing medicine

基　　金：河南省科技攻关项目(222102310640);郑州大学研究生教育研究重点项目(YJSJY202115);河南省医学科技攻关省部共建项目备选项目(2018010006);河南省卫生系统出国研修项目计划(2016021)。

摘　　要：目的分析口服咪达唑仑与右美托咪定滴鼻应用于小儿斜视矫正术前的镇静效果。方法将117例全身麻醉下行斜视矫正术的患儿应用随机数字表法分为3组,对照组(A组)、咪达唑仑组(B组)和右美托咪定组(C组),术前30 min给予相应的镇静措施。比较3组患儿入室时血流动力学指标、镇静评分、改良耶鲁术前焦虑量表(Cm-YPAS)评分和麻醉诱导期合作度量表(ICC)评分、术后镇静评分和围术期不良反应发生率。结果入室时,B组和C组Ramsay镇静评分高于A组,心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS)、Cm-YPAS评分和ICC评分低于A组(P<0.05);3组患儿拔除气管导管时间、术后1 d Ramsay镇静评分比较差异无统计学意义(P>0.05);C组术中阿托品使用量和不良反应发生率高于A组和B组(P<0.05)。结论口服咪达唑仑与右美托咪定滴鼻应用于全身麻醉下行斜视矫正术的患儿,术前均可以起到良好的镇静效果,但右美托咪定会引起患儿术中阿托品使用量的增加。Objective To analyze the sedative effect of oral midazolam and dexmedetomidine nasal drip in preoperative sedation during pediatric strabotomy.Methods A total of 117 children patients with strabotomy under general anesthesia were selected and randomly divided into the control group(group A),midazolam group(group B)and dexmedetomidine group(group C)according to the random number method.The corresponding sedative measures were given before operation.The hemodynamic indexes,sedation score,Cm-YPAS score and ICC score at entering the operation room,sedation scores after surgery and incidence rates of adverse reactions during the perioperative period were compared among the three groups.Results The Ramsay sedation score at entering the operation room in the group B and C was significantly higher than that in the group A,while the heart rates(HR),MAP,BIS,Cm-YPAS score and ICC score were lower than those in the group A(P<0.05).There was no significant difference in the extubation time and Ramsay sedation score on postoperative 1 d among the three groups(P>0.05).The intraoperative atropine usage amount and incidence rate of adverse reactions in the group C were higher than those in the group A and B(P<0.05).Conclusion The application of oral midazolam and dexmedetomidine nasal drip in pediatric strabotomy under general anesthesia has good sedative effect before operation.But dexmedetomidine would cause the atropine use amount increase during operation.

关 键 词：咪达唑仑口服 右美托咪定滴鼻 小儿斜视矫正术 镇静效果 

分 类 号：R614.2[医药卫生—麻醉学]