[1]杜化娟.右美托咪定滴鼻和静脉给药对小儿腺样体切除术的镇静效果比较[J].医学信息,2020,33(04):115-117.[doi:10.3969/j.issn.1006-1959.2020.04.035]
　DU Hua-juan.Comparison of Sedative Effect of Dexmedetomidine Nasal and Intravenous Administration on Adenoidectomy in Children[J].Medical Information,2020,33(04):115-117.[doi:10.3969/j.issn.1006-1959.2020.04.035]
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右美托咪定滴鼻和静脉给药对小儿腺样体切除术的镇静效果比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年04期
页码:
115-117
栏目:
临床研究
出版日期:
2020-02-15

文章信息/Info

Title:
Comparison of Sedative Effect of Dexmedetomidine Nasal and Intravenous Administration on Adenoidectomy in Children
文章编号:
1006-1959（2020）04-0115-03
作者:
杜化娟
（北京市门头沟区医院麻醉科，北京 100000）
Author(s):
DU Hua-juan
(Department of Anesthesiology,Mentougou District Hospital,Beijing 100000,China)
关键词:
右美托咪定; 静脉; 滴鼻; 腺样体切除术
Keywords:
Dexmedetomidine; Vein; Nasal drip; Adenoidectomy
分类号:
R726.1
DOI:
10.3969/j.issn.1006-1959.2020.04.035
文献标志码:
A
摘要:
目的 探讨右美托咪定滴鼻和静脉两种给药方式对小儿腺样体切除术的镇静效果。方法 选取 2015年1月~2018年10月我院收治的63例行小儿腺样体切除术患儿作为研究对象，随机分为DN组、DV组和C组，各21例。C组为空白对照组，麻醉前不做任何处理；DN组麻醉前30 min经鼻滴入右美托咪定（1 μg/kg），DV组麻醉前30 min静滴右美托咪定（1 μg/kg）。记录三组入室（T0）、给药10 min（T1）、给药20 min（T2）、给药30 min（T3）、插管时（T4）的心率（HR）、平均动脉压（MAP）、脑电双频指数（BIS）值，比较三组入睡时间、拔管时间、苏醒时间及不良反应发生情况。结果 ①T0时三组HR、MAP及BIS比较，差异无统计学意义（P＞0.05）；T1时DV组HR下降，且低于DN组、C组，差异有统计学意义（P＜0.05）；T2~T3时DN组、DV组HR均下降，且低于C组，差异有统计学意义（P＜0.05）。T3时C组MAP升高，且高于DN组、DV组，差异有统计学意义（P＜0.05）；T4时DV组、C组MAP高于T0时，DN组、DV组低于C组，差异有统计学意义（P＜0.05）。T3时C组BIS低于DN组、DV组，差异有统计学意义（P＜0.05）。②三组入睡时间（患儿无法入睡）比较，DV组＜DN组＜C组，差异有统计学意义（P＜0.05）；三组拔管时间比较，差异无统计学意义（P＞0.05）；三组苏醒时间比较，DN组＜C组＜DV组，但差异无统计学意义（P＞0.05）。③三组患儿均未发生呕吐、呛咳、呼吸抑制等不良反应，其中DV组出现1例窦缓、C组出现3例哭闹躁动，其中1例将静脉输液器挣脱。结论 右美托咪定鼻内滴注的起效时间慢于静脉滴注，但不良反应少，且不增加苏醒时间；两种途径给药均能获得满意的术前镇静，减少苏醒期躁动。但鼻内滴注无创，患儿更易接受。
Abstract:
Objective To investigate the sedative effects of dexmedetomidine nasal and intravenous administration on adenoidectomy in children. Methods 63 children who underwent adenoidectomy in our hospital from January 2015 to October 2018 were selected as the research subjects and randomly divided into DN group, DV group and C group, 21 cases each. Group C was a blank control group, and no treatment was performed before anesthesia; DN group was administered dexmedetomidine (1 μg/kg) by nasal drip 30 min before anesthesia;In the DV group, dexmedetomidine (1 μg/kg) was given intravenously 30 min before anesthesia. Record the three groups of admission (T0), 10 min (T1), 20 min (T2), 30 min (T3), heart rate (HR), mean arterial pressure (MAP) at intubation (T4) , EEG double frequency index (BIS) value, compared the three groups of sleep time, extubation time, wake-up time and adverse reactions. Results ①There was no significant difference in HR, MAP, and BIS between the three groups at T0 (P> 0.05); the HR in the DV group decreased at T1 and was lower than that in the DN and C groups,the difference was statistically significant(P<0.05); the HR in the T2-T3 DN group and the DV group decreased, and was lower than that in the group C,the difference was statistically significant (P<0.05). The MAP in group C increased at T3, and was higher than that in DN and DV groups,the difference was statistically significant(P<0.05); the MAP in the DV group and C group was higher than T0 at T4, and the DN group and DV group were lower than the group C,the difference was statistically significant (P<0.05). At T3, the BIS of group C was lower than that of DN group and DV group,the difference was statistically significant (P<0.05).②Comparison of falling asleep time (children could not fall asleep) between the three groups, DV group 0.05) ; Comparison of the wake-up time of the three groups, DN group 0.05). ③No adverse reactions such as vomiting, cough, and respiratory depression occurred in the three groups. 1 patient had sinus bradyscopy in the DV group, 3 patients had crying and restlessness in the group C, and one of them broke off the intravenous infusion set.Conclusion Intranasal infusion of dexmedetomidine has a slower onset time than intravenous infusion, but it has fewer adverse reactions and does not increase the wake-up time; both routes of administration can achieve satisfactory preoperative sedation and reduce restlessness during wake-up. However, intranasal instillation is non-invasive and it is more acceptable for children.

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更新日期/Last Update: 2020-02-15