[1]杜化娟.右美托咪定滴鼻和靜脈給藥對小兒腺樣體切除術的鎮靜效果比較[J].醫學信息,2020,(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,(04):115-117.[doi:10.3969/j.issn.1006-1959.2020.04.035]
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右美托咪定滴鼻和靜脈給藥對小兒腺樣體切除術的鎮靜效果比較()
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醫學信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期數:
2020年04期
頁碼:
115-117
欄目:
臨床研究
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
文章編號:
1006-1959(2020)04-0115-03
作者:
杜化娟
(北京市門頭溝區醫院麻醉科,北京 100000)
Author(s):
DU Hua-juan
(Department of Anesthesiology,Mentougou District Hospital,Beijing 100000,China)
關鍵詞:
右美托咪定靜脈滴鼻腺樣體切除術
Keywords:
DexmedetomidineVeinNasal dripAdenoidectomy
分類號:
R726.1
DOI:
10.3969/j.issn.1006-1959.2020.04.035
文獻標志碼:
A
摘要:
目的 探討右美托咪定滴鼻和靜脈兩種給藥方式對小兒腺樣體切除術的鎮靜效果。方法 選取 2015年1月~2018年10月我院收治的63例行小兒腺樣體切除術患兒作為研究對象,隨機分為DN組、DV組和C組,各21例。C組為空白對照組,麻醉前不做任何處理;DN組麻醉前30 min經鼻滴入右美托咪定(1 μg/kg),DV組麻醉前30 min靜滴右美托咪定(1 μg/kg)。記錄三組入室(T0)、給藥10 min(T1)、給藥20 min(T2)、給藥30 min(T3)、插管時(T4)的心率(HR)、平均動脈壓(MAP)、腦電雙頻指數(BIS)值,比較三組入睡時間、拔管時間、蘇醒時間及不良反應發生情況。結果 ①T0時三組HR、MAP及BIS比較,差異無統計學意義(P>0.05);T1時DV組HR下降,且低于DN組、C組,差異有統計學意義(P<0.05);T2~T3時DN組、DV組HR均下降,且低于C組,差異有統計學意義(P<0.05)。T3時C組MAP升高,且高于DN組、DV組,差異有統計學意義(P<0.05);T4時DV組、C組MAP高于T0時,DN組、DV組低于C組,差異有統計學意義(P<0.05)。T3時C組BIS低于DN組、DV組,差異有統計學意義(P<0.05)。②三組入睡時間(患兒無法入睡)比較,DV組<DN組<C組,差異有統計學意義(P<0.05);三組拔管時間比較,差異無統計學意義(P>0.05);三組蘇醒時間比較,DN組<C組<DV組,但差異無統計學意義(P>0.05)。③三組患兒均未發生嘔吐、嗆咳、呼吸抑制等不良反應,其中DV組出現1例竇緩、C組出現3例哭鬧躁動,其中1例將靜脈輸液器掙脫。結論 右美托咪定鼻內滴注的起效時間慢于靜脈滴注,但不良反應少,且不增加蘇醒時間;兩種途徑給藥均能獲得滿意的術前鎮靜,減少蘇醒期躁動。但鼻內滴注無創,患兒更易接受。
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.

參考文獻/References:

[1]羅玲,王春.鹽酸右美托咪定對小兒扁桃體、腺樣體切除術中應激反應的影響[J].解放軍醫藥雜志,2018,30(4):100-103. [2]張慧文,馬濤,趙麗,等.右美托咪定滴鼻對患兒扁桃體腺樣體切除術后恢復的影響[J].臨床麻醉學雜志2015,35(6):556-559. [3]畢瑩,紀宏新,陳文.右美托咪定滴鼻與咪達唑侖口服在小兒麻醉前鎮靜中的效果比較實用[J].臨床醫志,2016,20(19):143-144. [4]趙燕,高巨,林舜艷,等.右美托咪定術前滴鼻對全麻患兒術后行為改變影響[J].臨床麻醉學雜志,2016,32(3):222-225. [5]Harsoor SS,Rani DD,Lathashree S,et al.Effect of intraoperativedexmedetomidine infusion on sevofluranerequirement and blood glucose levels during entropy-guided general anesthesia[J].J Anaesthesiol Clin Pharmacol,2014,30(1):25-30. [6]Cimen ZS,Hanci A,Sivrikaya GU,et al.Comparison of buccaland nasal dexmedetomidine premedication for pediatric patients[J].Paediatr Anaesth,2013,23(2):134-138.

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