[1]张玉龙,廖顺芬,林丽佳,等.地佐辛不同给药方式联合右美托咪定滴鼻在小儿腹腔镜疝修补术中的效果[J].医学信息,2022,35(21):54-57，61.[doi:10.3969/j.issn.1006-1959.2022.21.011]
　ZHANG Yu-long,LIAO Shun-fen,LIN Li-jia,et al.Effect of Dezocine Administration Combined with Intranasal Administration of Dexmedetomidine in Laparoscopic Hernia Repair in Children[J].Journal of Medical Information,2022,35(21):54-57，61.[doi:10.3969/j.issn.1006-1959.2022.21.011]
点击复制

地佐辛不同给药方式联合右美托咪定滴鼻在小儿腹腔镜疝修补术中的效果()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年21期
页码:
54-57，61
栏目:
论著
出版日期:
2022-11-01

文章信息/Info

Title:
Effect of Dezocine Administration Combined with Intranasal Administration of Dexmedetomidine in Laparoscopic Hernia Repair in Children
文章编号:
1006-1959（2022）21-0054-05
作者:
张玉龙; 廖顺芬; 林丽佳; 等
（1.昆明市儿童医院麻醉科，云南 昆明 650228）；2．昆明市第三人民医院感染管理办公室，云南 昆明 650041）
Author(s):
ZHANG Yu-long; LIAO Shun-fen; LIN Li-jia; et al.
(1.Department of Anesthesioloey,Kunming Children’s Hospital,Kunming 650000,Yunnan,China;2.Infection Management Office,the Third People’s Hospital of Kunming,Kunming 650041,Yunnan,China)
关键词:
地佐辛; 腹股沟疝修补术; 右美托咪定; 小儿疝气
Keywords:
Dezocine; Inguinal hernia repair; Dexmedetomidine; Children with hernia
分类号:
R726.1
DOI:
10.3969/j.issn.1006-1959.2022.21.011
文献标志码:
A
摘要:
目的 探讨地佐辛不同给药方式联合右美托咪定滴鼻在小儿腹腔镜疝修补术中的效果。方法 选取2020年1月-2020年6月昆明市儿童医院行腹腔镜疝修补术患儿90例，随机分为三组：地佐辛静脉注射组（A组）、地佐辛静脉泵注组（B组）和空白对照组（C组）。三组患儿术前均予2 μg／kg右美托咪定滴鼻，入室后进行全麻气管插管。A组患儿手术开始时静脉注射地佐辛1 ml/kg（地佐辛稀释至0.1 mg/ml），并静脉泵注1 ml/kg生理盐水15 min泵完；B组患儿手术开始时静脉注射生理盐水1 ml/kg，并静脉泵注1 ml/kg地佐辛15 min泵完；C组患儿手术开始时静脉注射生理盐水1 ml/kg，并静脉泵注1 ml/kg生理盐水15 min泵完。术中七氟醚维持，术毕带管送入PACU，均不使用术后镇痛泵。记录患儿麻醉诱导前（T0）、手术开始时（T1）、建立气腹后（T2）、气腹后5 min（T3）、术毕（T4）、拔管时（T5）、出手术室时（T6）、入病房60 min（T7）、入病房120 min（T8）的平均动脉压及心率，烦躁（PAED）、镇痛（VAS）、镇静（Ramsay）评分、手术时间、术毕拔管时间、术毕至出手术室时间及术后消化道不良反应发生情况。结果 A组T3时平均动脉压和心率低于B组和C组（P＜0.05）；A组与B组T5、T6、T7时平均动脉压和心率低于C组（P＜0.05）。A组与B组T5、T8时PAED评分低于C组（P＜0.05）；A组和C组T6、T7时PAED评分高于B组（P＜0.05）。A组与B组T5、T6、T7、T8时VAS评分低于C组（P＜0.05）；B组T6时VAS评分低于A组（P＜0.05）。A组与B组T5、T6、T7时Ramsay评分高于C组（P＜0.05）。三组手术时间、术毕至出手术室时间比较，差异无统计学意义（P＞0.05）；A组与B组术毕拔管时间长于C组（P＜0.05）。B组与C组消化道不良事件发生率低于A组（P＜0.05）。结论 静脉泵注地佐辛联合右美托咪定滴鼻在小儿腹腔镜疝修补术中可使患儿循环更稳定，有效缓解术后患儿的疼痛程度，改善术后躁动，且消化道不良反应发生率更低。
Abstract:
Objective To investigate the effect of dezocine administration combined with intranasal administration of dexmedetomidine in laparoscopic hernia repair in children.Methods Ninety children with laparoscopic hernia repair in Kunming Children’s Hospital from January 2020 to June 2020 were selected. They were randomly divided into three groups: dezocine intravenous injection group (group A), dezocine intravenous pumping group (group B) and blank control group (group C). All patients in the three groups were given dexmedetomidine nasal drops 2 μg/kg before surgery, and tracheal intubation under general anesthesia after entering the room. In group A, 1 ml/kg desocine was intravenously injected at the beginning of surgery (desocine diluted to 0.1 mg/ml), and 1 ml/kg normal saline was intravenously pumped for 15 minutes. In group B, normal saline was injected intravenously at the beginning of surgery, and dexocine was injected intravenously at 1 ml/kg for 15 minutes. In group C, 1 ml/kg normal saline was injected intravenously at the beginning of surgery, and 1 ml/kg normal saline was pumped intravenously for 15 minutes. Sevoflurane was maintained during the operation, and PACU was delivered with a tube after the operation without postoperative analgesic pump. Before anesthesia induction (T0), at the beginning of surgery (T1), after pneumoperitoneum establishment (T2), 5min after pneumoperitoneum establishment (T3), at the end of surgery (T4), at extubation (T5), at departure from the operating room (T6), 60 min after admission to the ward (T7), and 120 min after admission to the ward (T8), the mean arterial pressure, heart rate, the scores of dysphoria (PAED), analgesia (VAS) and sedation (Ramsay)， the operative time, the time of biextubation, the time from the operation to the operation room, and the incidence of postoperative gastrointestinal adverse reactions in the three groups were recorded.Results Mean arterial pressure and heart rate at T3 in group A were lower than those in group B and C (P<0.05), mean arterial pressure and heart rate at T5, T6 and T7 in group A and group B were lower than those in group C (P<0.05). The PAED scores at T5 and T8 in group A and group B were lower than those in group C (P<0.05), the PAED scores at T6 and T7 in group A and group C were higher than those in group B (P<0.05). The VAS scores at T5, T6, T7 and T8 in group A and group B were lower than those in group C (P<0.05), the VAS score at T6 in group B was lower than that in group A (P<0.05), Ramsay scores at T5, T6 and T7 in group A and group B were higher than those in group C (P<0.05). There was no significant difference in the operation time and the time from the end of operation to the operation room among the three groups (P>0.05). The extubation time of group A and group B was longer than that of group C (P<0.05). The incidence of gastrointestinal adverse events in group B and group C was lower than that in group A (P<0.05).Conclusion Intravenous infusion of dezocine combined with dexmedetomidine nasal drip in pediatric laparoscopic hernia repair can make the circulation more stable, effectively relieve postoperative pain, improve postoperative agitation, and with lower incidence of gastrointestinal adverse reactions.

参考文献/References:

[1]韩玉洁.加速康复外科理念在小儿腹股沟斜疝腹腔镜手术围术期的应用效果[J].河南外科学杂志,2021,27(5):144-145.[2]王天龙,黄宇光.推动麻醉学向围手术期医学转变:《加速康复外科中国专家共识及路径管理指南(2018版)》麻醉部分解读[J].协和医学志,2018,9(6):481-484.[3]张锡凤,陈玲玲,安宏嫱,等.不同剂量右美托咪定对小儿腹部手术后躁动与氧化应激反应的影响[J].临床外科杂志,2021,29(11):1083-1085.[4]吕淑敏,祁炳杰,李建立.右美托咪定对小儿腹腔镜疝囊高位结扎术全麻苏醒质量的影响[J].河北医药,2016,38(6):859-861.[5]Jeongmin K,So YK,Jae HL,et al.Low-dose dexmedetomidine reduces emergence agitation after desflurane anaesthesia in children undergoing strabismus surger[J].Yonsei Med J,2014,55(2):508-516.[6]岳冬梅,刘苏,张月英,等.右美托咪定术前滴鼻在小儿腹股沟疝手术中的应用[J].重庆医学,2016,45(8):1034-1036.[7]Wang L,Huang L,Zhang T,et al.Comparison of Intranasal?Dexmedetomidine?and Oral Midazolam for Premedication in Pediatric Dental Patients under General Anesthesia: A Randomised Clinical Trial[J].Biomed Res Int,2020:5142913.[8]Kumar L,Kumar A,Panikkaveetil R,et al.Efficacy of intranasal dexmedetomidine versus oral midazolam for paediatric premedication[J].Indian J Anaesth,2017,61(2):125-130.[9]姜金锦,掌曼青.右美托咪定对腹腔镜疝修补术患儿血流动力学、苏醒质量及术后镇痛的影响[J]. 中国基层医药,2021,28(7):1083-1086.[10]Hassan PF,Hassan AS,Elmetwally SA.Caudal Analgesia for Hypospadias in Pediatrics: Comparative Evaluation of Adjuvants Dexamethasone and Dexmedetomidine?Combination versus Dexamethasone or Dexmedetomidine to Bupivacaine: A Prospective,Double-Blinded,Randomized Comparative Study[J].Anesth Essays Res,2018,12(3):644-650.[11]罗瑞敏,尧永华.应重视右美托咪定在化疗相关性恶心呕吐中的应用[J].实用医学杂志,2020,36(6):707-710.[12]Mahmoud M,Barbi E,Mason KP.Dexmedetomidine: What’s New for Pediatrics? A Narrative Review[J].J Clin Med,2020,9(9):2724.[13]Sperotto F,Mondardini MC,Vitale F.Prolonged sedation in critically ill children: is dexmedetomidine a safe option for younger age? Anoff-label experience[J].Minerva Anestesiol,2019,85(2):164-172.[14]徐国勇.不同剂量地佐辛对腹腔镜斜疝修补术患儿全麻苏醒期躁动的影响[J]. 广西医学,2018,40(10):1157-1159,1170.[15]纪怀珠,欧阳碧山,宁巧明.地佐辛预防小儿全身麻醉苏醒期躁动的临床研究[J].中国现代医学杂志,2017,27(17):108-112.[16]陈明富,张干,李胜利,等.地佐辛与舒芬太尼预防阑尾切除术内脏牵拉反应效果的比较[J].临床军医杂志,2012,40(6):1381-1382.[17]Li X,Xia,Li W.Comparison of the effects of dezocine,fentanyl,and placebo on emergence agitation after sevoflurane anesthesia in children[J].Int J Clin Pharmacol Ther,2015,53(3):241-246.[18]周伟鑫.探讨地佐辛在预防小儿腹腔镜斜疝手术苏醒期躁动的应用[D].汕头:汕头大学,2017.[19]Zhou ZG,Liu R,Tan HL,et al.The application of dexmedetomidine combined withdezocine in thoracoscopic radical resection of lungcancer and its effect on awakening quality of patients [J].Eur Rev Med Pharmacol Sic,2019,23(17):7694-7702.

相似文献/References:

[1]张 燕,王永娟.舒芬太尼复合地佐辛用于痔上黏膜环切术后自控镇痛的剂量分析[J].医学信息,2019,32(04):140.[doi:10.3969/j.issn.1006-1959.2019.04.045]
　ZHANG Yan,WANG Yong-juan.Dose Analysis of Sufentanil Combined with Dizocine for Self-controlled Analgesia after Supraorbital Mucosal Circumcision[J].Journal of Medical Information,2019,32(21):140.[doi:10.3969/j.issn.1006-1959.2019.04.045]
[2]刘思远.地佐辛与瑞芬太尼用于无痛人工流产麻醉的效果比较[J].医学信息,2019,32(22):123.[doi:10.3969/j.issn.1006-1959.2019.22.040]
　LIU Si-yuan.Effect Comparison of the Dizocine and Remifentanil on Painless Artificial Abortion[J].Journal of Medical Information,2019,32(21):123.[doi:10.3969/j.issn.1006-1959.2019.22.040]
[3]王建华.舒芬太尼和地佐辛预防瑞芬太尼麻醉后疼痛过敏的效果比较[J].医学信息,2019,32(24):151.[doi:10.3969/j.issn.1006-1959.2019.24.054]
　WANG Jian-hua.Comparison of Sufentanil and Dezocine in Preventing Pain Allergy after Remifentanil Anesthesia[J].Journal of Medical Information,2019,32(21):151.[doi:10.3969/j.issn.1006-1959.2019.24.054]
[4]帅 亮,邹恒美.地佐辛和纳布啡在腹腔镜手术中的镇痛效果及安全性研究[J].医学信息,2023,36(14):129.[doi:10.3969/j.issn.1006-1959.2023.14.026]
　SHUAI Liang,ZOU Heng-mei.Study on Analgesic Effect and Safety of Dezocine and Nalbuphine in Laparoscopic Surgery[J].Journal of Medical Information,2023,36(21):129.[doi:10.3969/j.issn.1006-1959.2023.14.026]
[5]张明月,夏晓琼,余泳波,等.不同阿片类药物对老年患者无痛肠镜检查延迟性恶心呕吐的影响[J].医学信息,2024,37(10):121.[doi:10.3969/j.issn.1006-1959.2024.10.025]
　ZHANG Ming-yue,XIA Xiao-qiong,YU Yong-bo,et al.Effects of Different Opioids on Delayed Nausea and Vomiting in Elderly Patients Undergoing Painless Enteroscopy[J].Journal of Medical Information,2024,37(21):121.[doi:10.3969/j.issn.1006-1959.2024.10.025]
[6]余静平.异丙酚复合地佐辛预防性镇痛对腹腔镜下胆囊切除术患者应激反应及术后疼痛的影响[J].医学信息,2025,38(03):122.[doi:10.3969/j.issn.1006-1959.2025.03.023]
　YU Jingping.Effect of Preventive Analgesia with Propofol Combined with Dezocine on Stress Response and Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy[J].Journal of Medical Information,2025,38(21):122.[doi:10.3969/j.issn.1006-1959.2025.03.023]

更新日期/Last Update: 1900-01-01