摘要
目的分析不同剂量右美托咪定滴鼻对七氟烷麻醉腹股沟疝患儿应激反应和苏醒期躁动的影响。方法选择2015年1月至2018年12月在惠州市中心人民医院175例腹股沟疝患儿的临床资料,按简单随机抽样分为A组(57例)、B组(61例)、C组(57例),分别予以1.0、1.5、2.0μg/kg右美托咪定滴鼻,比较各组患儿苏醒时间、不同时间点血流动力学指标、应激反应指标、躁动评分、躁动发生率及其他不良反应发生情况。结果A组苏醒时间少于B组及C组,且B组苏醒时间少于C组(P<0.05)。手术开始即刻、拔喉罩即刻3组心率(HR)、平均动脉压(MAP)均较滴鼻前上升,A组HR、MAP高于B组及C组(P<0.05),手术开始即刻,3组应激反应指标均较术前上升,且A组高于B组及C组(P<0.05),B组HR、MAP、应激反应指标与C组比较差异无统计学意义(P>0.05)。苏醒即刻、苏醒后5 min及苏醒后15 min A组躁动评分均高于B组及C组(P<0.05),B组和C组躁动评分比较差异无统计学意义(P>0.05)。A组躁动、呛咳发生率高于B组及C组,A、B组恶心、呕吐发生率低于C组(P<0.05)。结论1.5μg/kg右美托咪定滴鼻更适合小儿七氟烷麻醉腹股沟疝手术,可维持血流动力学的稳定,减轻应激反应和苏醒期躁动,且不增加药物不良反应的发生率。
Objective To analyze the effect of different doses of dexmedetomidine nasal drops on stress response and agitation in recovery period in children with hernia under sevoflurane anesthesia.Methods 175 cases of pediatric hernia were divided into group A(n=57),group B(n=61)and group C(n=57)according to simple random method,and 1.0μg/kg,1.5μg/kg and 2.0μg/kg dexmedetomidine were given nasal drops,respectively.The recovery time,hemodynamics,stress response index,agitation score at different time points,incidence rate of agitation and other adverse reactions in each group were compared.Results The awakening time of group A was lesser than that of group B and group C,and the awakening time of group B was lesser than that of group C(P<0.05).The heart rate(HR)and mean arterial pressure(MAP)of the three groups increased immediately after surgery and immediately after removal of the laryngeal mask compared with that before nasal drops.The HR and MAP of group A were higher than those of group B and group C(P<0.05),immediately after the operation,the indicators of stress response in all three groups were increased compared with that before the operation,and group A was higher than group B and group C(P<0.05).There was no significant difference in HR,MAP and stress response index between group B and group C(P>0.05).Immediately after awakening,at 5 min after awakening and 15 min after awakening,the agitation score of group A were higher than those of group B and group C(P<0.05),and there was no statistical significance between group B and group C(P>0.05).The incidence of agitation and cough in group A was higher than that in group B and group C,while the incidence of nausea and vomiting in groups A and B was lower than that in group C(P<0.05).Conclusion 1.5μg/kg dexmedetomidine nasal drops are more suitable for pediatric hernia surgery under sevoflurane anesthesia.It can maintain the stability of hemodynamics,reduce stress response and agitation during recovery period,and do not increase the incidence of adverse drug reactio
作者
江鹏
候芝绮
罗德兴
Jiang Peng;Hou Zhiqi;Luo Dexing(Huizhou Minicipal Central Hospital,Guangdong,Huizhou 516000,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2020年第2期150-154,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
腹股沟
儿童
七氟烷
不同剂量
右美托咪定滴鼻
应激反应
苏醒期躁动
Hernia,inguinal
Child
Sevoflurane
Different doses
Dexmedetomidine nasal drops
Stress reaction
Agitation during awakening period
