麻醉诱导期右美托咪定滴鼻在患儿中的镇静及躁动研究

探究麻醉诱导期右美托咪定滴鼻对患儿术中及术后的镇静效果。择期手术患儿60例,随机分为3组,D1组、D2组和C组,麻醉诱导期分别给予1.0μg/kg右美托咪定滴鼻,2.0μg/kg右美托咪定滴鼻和等量生理盐水滴鼻。结果三组滴鼻前时刻T0血流动力学无差异（P〉0.05）,滴鼻后45min时刻（T1）和拔出导管或喉罩时刻（T2）D1组与D2组较C组心率和血压低（P〈0.05）,但在允许范围内;T1、T2时刻,D1组与D2组差异不明显（P〉0.05）;术后躁动评分,D1组与D2组较C组低（P〈0.05）,D2组较D1组低（P〈0.05）;术后疼痛评分,D1组与D2组较C组低（P〈0.05）,D1组与D2组差异无统计学意义（P〉0.05）;术后镇痛需求,D1组与D2组较C组少（P〈0.05）;不良反应无差异（P〉0.05）。麻醉诱导期右美托咪定滴鼻起到有效镇静作用,减少麻醉苏醒期躁动,减轻疼痛。2.0μg/kg的右美托咪定剂量麻醉诱导期滴鼻减少术后躁动效果更明显,不增加不良反应的发生。

Study of Postoperative Sedation and Emergence Delirium in Children with Intranasal Dexmedetomidine during Anesthesia Induction

The aim of this study was to investigate the effect of intranasal dexmedetomidine on postoperative sedation and emergence delirium in children during anesthesia induction.60 infants with general anesthesia,aged from 3years old to 6years old,were randomly divided into three groups,namely group D1,group D2,group C,received intranasal dexmedetomidine 1.0μg/kg,2.0μg/kg,normal saline solution twice in each nostril.There was no significantly difference at T0 time among the three groups in HR and BP,and at T1 and T2time between group D1 and group D2（P〉0.05）;HR and BP of group D1 and group D2 were significantly lower than group C at T1 and T2time（P〈0.05）.Delirium scores of group D1 and group D2 were significantly lower than group C（P〈0.05）;Delirium scores of group D2 were significantly lower than group D1（P〈0.05）;pain scores of group D1 and group D2 were significantly lower than group C（P〈0.05）;There was no significant difference in pain scores between group D1 and group D2（P 〉0.05）.The children needed postoperative analgesics of group D1 and group D2 were less than group C（P〈0.05）.There was no significantly difference in adverse reactions among three groups（P〉0.05）.These results suggested that intranasal administration of dexmedetomidine had good effect of sedation,and reducing emergence delirium and postoperative pain.Intranasal administration of 2.0μg/kg dexmedetomidine is more effective,and not increasing the incidence of adverse reactions.