摘要
目的 探讨扁桃体腺样体切除术患儿术前使用艾司氯胺酮复合右美托咪定滴鼻对术前分离焦虑和术后谵妄的影响。方法 行扁桃体腺样体切除术患儿118例随机分为三组。麻醉诱导前20 min, DK组(40例)给予右美托咪定1μg/kg和艾司氯胺酮0.5 mg/kg缓慢滴鼻,D组(39例)给予右美托咪定2μg/kg缓慢滴鼻,C组(39例)给予生理盐水缓慢滴鼻作为对照。记录入手术室时改良警觉/镇静(MOAA/S)评分;记录患儿与父母分离时的焦虑量表(PSAS)评分、诱导时的面罩接受度量表(MAS)评分及麻醉苏醒期谵妄发生率;记录麻醉苏醒时间以及麻醉恢复室(PACU)停留时间;同时记录两组不良反应发生情况。结果 DK组MOAA/S评分、PSAS评分、MAS评分和苏醒期谵妄发生率低于D组和C组(P<0.05)。DK组和D组患儿苏醒时间较C组增加(P<0.05)。DK组的PACU停留时间短于其他两组(P<0.05)。DK组术后疼痛发生率较C组下降(P<0.05),心动过缓发生率较D组降低(P<0.05)。结论 术前艾司氯胺酮复合右美托咪定滴鼻可以改善扁桃体腺样体切除术患儿术前分离焦虑和术后苏醒期谵妄。
Objective To investigate the effects of preoperative use of esketamine combined with dexmedetomidine nasal drops on preoperative separation anxiety and postoperative delirium in pediatric tonsillectomy.Methods A total of 118 children undergoing tonsillectomy were randomly divided into three groups.At 20 minutes before anesthesia induction,the nasal dropping with dexmedetomidine 1μg/kg and esketamine 0.5 mg/kg was performed in group DK(40 cases),which with dexmedetomidine 2μg/kg was performed in group D(39 cases)and with normal saline was performed in group C(39 cases)as the control.The modified observe's assessment of alertness/sedation(MOAA/S)score at entering operating room was evaluated.The parental separation anxiety scale(PSAS)score,mask acceptance scale(MAS)score and the incidence of delirium during anesthesia recovery were recorded.The time of anesthesia recovery and postanesthesia care unit(PACU)stay were recorded.The occurrence of adverse reactions was recorded.Results The MOAA/S,PSAS score,MAS score and delirium incidence in group DK were significantly lower than those in groups of D and C(P<0.05).Compared with group C,the awakening times of the children in groups of DK and D were significantly increased(P<0.05).The PACU stay time was significantly shorter in group DK than that in groups of D and C(P<0.05).Compared with group C,the incidence of postoperative pain was significantly reduced in group DK(P<0.05).Compared with group D,the incidence of bradycardia was significantly reduced in group DK(P<0.05).Conclusion Before anesthesia induction in the children undergoing tonsillectomy,nasal dropping with esketamine combined with dexmedetomidine can better improve the preoperative separation anxiety and reduce the occurrence of postoperative awakening delirium.
作者
吴超
钱宁
刘莹
WU Chao;QIAN Ning;LIU Ying(Department of Anesthesiology,Affiliated Dongyang Hospital,Wenzhou Medical University,Dongyang 322100,CHINA)
出处
《江苏医药》
CAS
2024年第7期707-710,共4页
Jiangsu Medical Journal
基金
中国红十字基金会医学赋能公益专项基金“医学赋能与人才培养计划”科研项目。
