循经抚触点按法联合小剂量右美托咪定在小儿全麻术后苏醒期躁动中的应用研究  

Study on the application of meridian-soothing contact method combined with low dose of dexmedetomidine in agitation during recovery period after general anesthesia in pediatric patients

作　　者：卢舒雨 陶品月 梁奕 曾菲[1] 刘娟娟 李颖[1] 张明明[1] 李涛[1] 刘秋艳 LU Shuyu;TAO Pinyue;LIANG Yi;ZENG Fei;LIU Juanjuan;LI Ying;ZHANG Mingming;LI Tao;LIU Qiuyan(Department of Anesthesiology,The Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院麻醉科,广西南宁530007

出　　处：《麻醉安全与质控》2024年第6期309-312,共4页Perioperative Safety and Quality Assurance

基　　金：广西中医药适宜技术开发与推广项目(GZSY21-58);广西医疗卫生适宜技术开发与推广应用项目(S2021118);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20211197)。

摘　　要：目的探讨循经抚触点按法联合小剂量右美托咪定在小儿全麻术后躁动中的应用效果。方法选取2022-07/2023-12期间在广西医科大学第二附属医院麻醉科复苏的全麻术后躁动的患儿120例作为研究对象。采用随机数字表法将患儿分为小剂量右美托咪定组(对照组,n=60)和循经抚触点按法联合小剂量右美托咪定组(观察组,n=60),年龄3~10岁,ASA分级Ⅰ或Ⅱ级。对照组患儿复苏过程出现躁动后,给予单次静脉滴注盐酸右美托咪定0.2μg/kg;观察组患儿复苏过程出现躁动后,予以单次右美托咪定0.2μg/kg静脉滴注,在此基础上,加用手掌及手指抚触患儿心经、脾经,点按百会、内关(双)、天枢(双)、足三里(双)、三阴交(双)、涌泉(双)穴位,每个穴位按压1~3 min,循经抚触点按过程持续10~15 min。比较两组患儿再次躁动、术后恶心呕吐发生率、复苏时间以及患儿家属满意度。结果观察组患儿再次躁动及恶心呕吐的发生率为15.0%和18.3%,对照组为33.3%和38.3%,观察组复苏时间为32.0(24.5,55.0)min,对照组为48.5(34.0,72.0)min;观察组患儿家属的满意度为96.7%,对照组为81.7%,两组比较差异有统计学意义(P<0.05)。结论循经抚触点按法联合小剂量右美托咪定可有效控制小儿全麻术后苏醒期再次躁动、恶心呕吐发生率,缩短复苏时间,提高患儿家属的满意度,可为临床防治小儿全麻术后苏醒期躁动提供参考。Objective To investigate the effect of meridian-soothing contact method combined with low dose of dexmedetomidine in the treatment of agitation after general anesthesia in pediatric pationts.Methods A total of 120 pediatric patients,aged 3-10 years,ASAⅠorⅡ,with restlessness after general anesthesia who were admitted to the Second Affiliated Hospital of Guangxi Medical University from July 2022 to December 2023 were selected and divided into low dose dexmedetomidine group(control group,n=60)and meridian-soothing contact method combined with low dose of dexmedetomidine group(observation group,n=60)according to random number table method.After agitation during resuscitation,the control group was given a single intravenous infusion of dexmedetomidine hydrochloride 0.2μg/kg.Meanwhile,the observation group were given a single 0.2μg/kg intravenous infusion of dexmedetomidine.After that,nurses touched the heart and spleen channels of the children with palms and fingers,and pressed Baihui,Neiguan(double),Tianshu(double),Zusanli(double),Sanyinjiao(double)and Yongquan(double)points,pressing each point for 1-3 min.The process of meridian-soothing contact lasts 10 to 15 min.The incidence of recurrent agitation,postoperative nausea and vomiting,resuscitation time and family satisfaction were compared between the two groups.Results The incidence of recurrent agitation,nausea and vomiting was 15.0%and 18.3%in the observation group,33.3%and 38.3%in the control group,and the resuscitation time was 32.0(24.5,55.0)min in the observation group and 48.5(34.0,72.0)min in the control group.The satisfaction of family members in observation group and control group was 96.7%and 81.7%,and the difference between the two groups was statistically significant(P<0.05).Conclusion The combination of meridian-soothing contact method and low-dose dexmedetomidine can effectively control the incidence of recurrent agitation,nausea and vomiting in the recovery period of children after general anesthesia,shorten the recovery time,and improve the s

关 键 词：循经抚触点按法 右美托咪定 全身麻醉 苏醒期躁动 

分 类 号：R726.1[医药卫生—儿科]