右美托咪定复合艾司氯胺酮滴鼻用于小儿先天手足畸形矫形手术  

Dextromefrox and ketamine nasal drops are used in orthopedic surgery for congenital hand-foot deformity in children

作　　者：钟凤珍 孙承毅 卢波 ZHONG Feng-zhen;SUN Cheng-yi;LU Bo(Department of Anesthesiology,Dongguan Hospital of Integrated Traditional Chinese and Western Medicine,Dongguan 532800,China)

机构地区：[1]东莞市中西医结合医院麻醉科,广东东莞532800

出　　处：《中国处方药》2024年第6期116-118,共3页Journal of China Prescription Drug

摘　　要：目的探讨右美托咪定复合艾司氯胺酮滴鼻用于小儿先天手足畸形矫形手术的应用效果。方法选取东莞市中西医结合医院2022年1月~2023年4月收治的先天手足畸形患儿64例,均择期拟行矫形手术治疗,采用随机数字表法分为试验组(n=32)与对照组(n=32)。对照组患儿予以2μg/kg右美托咪定滴鼻,试验组患儿予以2μg/kg右美托咪定+1 mg/kg艾司氯胺酮滴鼻。比较两组患儿的镇静效果、氧化应激指标、血气指标及不良反应发生情况。结果试验组患儿补救镇静率低于对照组,镇静起效时间、苏醒时间、麻醉后监测治疗室停留时间短于对照组,差异有统计学意义(P<0.05)。试验组患儿给药后30 min的威斯康星州儿童医院镇静量表(CHW)评分低于对照组,心率(HR)水平高于对照组,差异有统计学意义(P<0.05)。对照组镇静后的各项氧化应激指标均高于镇静前(P<0.05)。试验组镇静前和镇静后的血清皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)指标对比,差异无统计学意义(P>0.05),但镇静后的Cor、NE、E、心肌肌钙蛋白I(c TnI)水平低于对照组(P<0.05)。试验组患儿不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合艾司氯胺酮滴鼻可优化小儿先天手足畸形矫形手术的镇静效果,缩短镇静起效时间,降低患儿应激反应,术后苏醒质量高,不良反应较少,安全性较高。Objective To investigate the effect of dexmedetomidine combined with esketamine nasal drops in orthopedic surgery for congenital hand-foot deformity in children.Methods A total of 64 children with congenital hand-foot deformity admitted to Dongguan Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to April 2023 were selected and were all selected for orthopaedic surgery.They were divided into the experimental group(n=32)and the control group(n=32)by random number table method.The control group was given 2μg/kg dexmedetomidine nasal drops,and the experimental group was given 2μg/kg dexmedetomidine+1 mg/kg esketamine nasal drops.The sedation effect,blood gas index and the occurrence of adverse reactions were compared between the two groups.Results The rate of remedial sedation in the experimental group was lower than that in the control group,and the time of sedation onset,recovery time and stay in the monitoring treatment room after anesthesia were shorter than those in the control group,with statistical significance(P<0.05).The score of the children’s Hospital of Wisconsin Sedation Scale(CHW)30 min after administration of the experimental group was lower than that of the control group,and the heart rate(HR)level was higher than that of the control group,with statistical significance(P<0.05).The indexes of the control group after analgesia were higher than those before analgesia(P<0.05).The Cor,NE and E indexes of the experimental groups were significantly different before and after analgesia(P<0.05),but the levels of serum cortisol(Cor),norepinephrine(NE),epinephrine(E)and cardiac troponin I(cTnI)were lower than those of the control group(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with esketamine nasal drops can optimize the sedative effect of orthopaedic surgery for congenital hand-foot deformity in children,shorten the

关 键 词：小儿先天手足畸形 矫形手术 右美托咪定 艾司氯胺酮 滴鼻 镇静 

分 类 号：R726.1[医药卫生—儿科]