右美托咪定鼻喷雾剂对日间手术患儿术前镇静及苏醒期躁动的影响  

Effect of Dexmedetomidine Nasal Spray on preoperative sedation and emergence agitation in children undergoing day surgery

作　　者：金琪琪 张焰统 陈刚 许梦婷 周盈丰 袁开明[1] 李军[1] JIN Qiqi;ZHANG Yantong;CHEN Gang;XU Mengting;ZHOU Yingfeng;YUAN Kaiming;LI Jun(Department of Anesthesiology and Perioperative Medicine,the Second Affiliated Hospital of Wenzhou Medical UniversityYuying Children’s Hospital,Zhejiang Province,Wenzhou325024,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院麻醉与围术期医学科,浙江温州325024

出　　处：《中国医药导报》2024年第28期138-141,146,共5页China Medical Herald

基　　金：重大新药创制国家科技重大专项项目(2020ZX09201002-004)。

摘　　要：目的探讨右美托咪定鼻喷雾剂对日间手术患儿术前镇静及苏醒期躁动(EA)的影响。方法选取2023年12月至2024年2月在温州医科大学附属第二医院行日间扁桃体腺样体切除术患儿80例为研究对象,按随机数字表法将其分为生理盐水鼻喷组(NS组)、右美托咪定鼻喷组(DF组),每组40例。两组均在麻醉诱导前30 min接受鼻喷给药。比较两组鼻喷前、麻醉诱导前改良耶鲁术前焦虑量表(m-YPAS)评分;比较两组EA发生率、满意分离率、满意诱导率、苏醒时间、麻醉后恢复室(PACU)停留时间、术后不良行为发生率、术前用药满意度评分;观察两组不良反应发生情况。结果麻醉诱导前,DF组m-YPAS评分低于鼻喷前,且低于NS组(P<0.05)。DF组EA发生率低于NS组(P<0.05)。两组满意分离率、出院时间、术后不良行为发生率比较,差异无统计学意义(P>0.05);DF组满意镇静率、满意诱导率高于NS组,苏醒时间、PACU停留时间长于NS组(P<0.05)。两组均未出现严重不良事件及术后恶心、呕吐事件。结论右美托咪定鼻喷雾剂给药能有效改善日间手术患儿的术前焦虑情况,减少EA的发生且有较好的安全性。Objective To investigate the effect of Dexmedetomidine Nasal Spray on preoperative sedation and emergence agitation(EA)in children undergoing day surgery.Methods A total of 80 children underwent adenotonsillectomy day surgery in the Second Affiliated Hospital of Wenzhou Medical University from December 2023 to February 2024 were selected as the study objects.They were divided into normal saline nasal spray group(NS group)and Dexmedetomidine Nasal Spray group(DF group)according to random number table method,with 40 cases in each group.Both groups received nasal spray 30 min before anesthesia induction.The modified Yale preoperative anxiety scale(m-YPAS)scores before nasal spray and anesthesia induction were compared between the two groups;the incidence of EA,satisfactory separation rate,satisfactory induction rate,recovery time,post-anesthesia care unit(PACU)residence time,postoperative adverse behavior rate,and preoperative medication satisfaction score were compared between the two groups;and the occurrence of adverse reactions in the two groups was observed.Results Before anesthesia induction,m-YPAS score in DF group was lower than before nasal spray and lower than that in NS group(P<0.05).The incidence of EA in DF group was lower than that in NS group(P<0.05).There were no significant differences in satisfactory separation rate,discharge time,and incidence of postoperative adverse behavior between the two groups(P>0.05);the satisfied sedation rate and satisfactory induction rate of DF group were higher than those of NS group,and the recovery time and PACU residence time of DF group were longer than those of NS group(P<0.05).No serious adverse events or postoperative nausea or vomiting occurred in both groups.Conclusion The administration of Dexmedetomidine Nasal Spray can effectively improve the preoperative anxiety of children undergoing day surgery,reduce emergence agitation,and has a good safety.

关 键 词：右美托咪定 喷雾剂 扁桃体腺样体切除术 镇静 儿童 

分 类 号：R614.2[医药卫生—麻醉学]