北京大学学报(医学版) ›› 2018, Vol. 50 ›› Issue (6): 1078-1082. doi: 10.19723/j.issn.1671-167X.2018.06.024
Ling GAO(),Yun LIU,Xu-dong YANG
摘要:
目的: 观察全身麻醉下牙病治疗患儿鼻喷右美托咪定(dexmedetomidine,DEX)对术前紧张情绪、父母分离焦虑、面罩接受程度和术后躁动的影响。方法: 选择北京大学口腔医院儿童口腔门诊全身麻醉下牙病治疗的患儿60例,年龄2~9岁,随机分为2组:对照组术前30 min经鼻喷入生理盐水0.02 mL/kg,DEX组喷入DEX 2 μg/kg(药物使用原液)。观察和记录患儿给药前及给药后10、20、25、30 min的心率(heart rate,HR)、脉搏血氧饱和度(oxygen saturation,SpO2)以及给药30 min后的Ramsay镇静评分、分离焦虑评分、面罩吸入诱导接受度评分和术后躁动评分及并发症的情况。结果: 两组患儿的年龄、体重、性别构成、手术时间、拔管时间和苏醒时间相似,差异无统计学意义。DEX组患儿与父母的分离焦虑、面罩接受程度明显优于对照组(56.7% vs. 26.7%,73.3% vs. 40%,P均<0.05),术后躁动评分在两组间差异无统计学意义(P>0.05)。与对照组相比,DEX组患儿给药20 min后HR有所下降,差异有统计学意义[(97.13±12.93)次/min vs. (104.53±11.97)次/min, P<0.05]。两组患儿的SpO2未见明显差异,且均未见心动过缓、低氧血症的发生。结论: 全身麻醉前经鼻喷入DEX可以产生良好的术前镇静作用,改善与父母的分离焦虑,提高面罩接受度。两组患儿苏醒质量高,无明显的苏醒期躁动、呼吸抑制等并发症。鼻喷DEX 2 μg/kg是一种安全有效的儿童术前给药方式。
中图分类号:
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