右美托咪定滴鼻联合不同剂量舒芬太尼对扁桃体腺样体切除术患儿苏醒期躁动及疼痛的影响  

Effect of Dexmedetomidine Nasal Drip Combined with Different Doses of Sufentanil on Emergence Agitation and Pain in Children Undergoing Tonsillectomy and Adenoidectomy

作　　者：陈艾琼 李帆 杨桥 CHEN Aiqiong;LI Fan;YANG Qiao(Department of Anesthesiology,Ganzhou Maternal and Child Health Hospital,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣州市妇幼保健院麻醉科,江西赣州341000

出　　处：《医学信息》2024年第22期106-109,共4页Journal of Medical Information

基　　金：赣州市科技计划项目(编号:GZ2023ZSF244)。

摘　　要：目的探讨右美托咪定滴鼻联合不同剂量舒芬太尼对小儿扁桃体腺样体切除术后苏醒期躁动和疼痛的影响。方法选取2022年1月-2023年5月赣州市妇幼保健院进行扁桃体腺样体切除术的患儿100例的临床资料,按照随机数字表法将其分为对照组和研究组,每组50例。对照组采用右美托咪定滴鼻联合高剂量舒芬太尼治疗,研究组采用右美托咪定滴鼻联合低剂量舒芬太尼治疗。对比两组患儿手术及术后恢复时间[手术时间、自主呼吸时间、气管导管拔除时间、睁眼时间]、苏醒期躁动评分、疼痛评分、血流动力学指标[心率、脉搏血氧饱和度(SpO_(2))]、不良反应(嗜睡、恶心呕吐、舌后坠和鼻咽出血)发生率。结果两组患儿手术时间、自主呼吸时间、气管导管拔除时间、睁眼时间比较,差异无统计学意义(P>0.05);研究组PAED评分低于对照组(P<0.05);研究组不同时间点T_(1)、T_(2)、T_(3)、T_(4)的FLACC评分均低于对照组(P<0.05);两组T_(1)、T_(2)、T_(3)、T_(4)时刻HR水平低于T0时刻,但研究组高于对照组(P<0.05)。两组各时刻SpO_(2)水平比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定滴鼻联合低剂量舒芬太尼在扁桃体腺样体切除术患儿中的应用效果确切,能够减少患儿苏醒期躁动程度和术后疼痛水平,维持患儿血流动力学稳定,同时减少术后手术及麻醉相关并发症的发生。Objective To investigate the effect of dexmedetomidine nasal drip combined with different doses of sufentanil on agitation and pain during recovery period after pediatric adenotonsillectomy.Methods The clinical data of 100 children undergoing tonsil adenoidectomy in Ganzhou Maternal and Child Health Hospital from January 2022 to May 2023 were selected and divided into control group and study group according to the random number table method,with 50 children in each group.The control group was treated with dexmedetomidine nasal drip combined with high-dose sufentanil,and the study group was treated with dexmedetomidine nasal drip combined with low-dose sufentanil.The operation and postoperative recovery time[operation time,spontaneous breathing time,tracheal catheter removal time,eye opening time],emergence agitation score,pain score,hemodynamic index[heart rate,pulse oxygen saturation(SpO_(2))],incidence of adverse reactions(drowsiness,nausea and vomiting,glossocoma and nasopharyngeal hemorrhage)were compared between the two groups.Results There was no significant difference in operation time,spontaneous breathing time,tracheal extubation time and eye opening time between the two groups(P>0.05).The PAED score of the study group was lower than that of the control group(P<0.05).The FLACC scores of T_(1),T_(2),T_(3)andT_(4)and T4 in the study group were lower than those in the control group at different time points(P<0.05).The HR level of the two groups at T_(1),T_(2),T_(3)andT_(4) was lower than those at T0,but that in the study group was higher than that in the control group(P<0.05).There was no significant difference in SpO_(2) level between the two groups at each time point(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine nasal drip combined with low-dose sufentanil has a definite application effect in children undergoing tonsillectomy and adenoidectomy,which can reduce the degree of agitation and postoperative pain during

关 键 词：右美托咪定滴鼻 不同剂量舒芬太尼 扁桃体腺样体切除术患儿 苏醒期躁动 疼痛 

分 类 号：R726.1[医药卫生—儿科]