摘要
目的探讨雾化吸入右美托咪定对行纤维支气管镜检查患儿的影响。方法选取拟行纤维支气管镜检查患儿90例,随机分为3组,每组各30例。检查前C组雾化吸入利多卡因4 mg·kg^(-1);ID组雾化吸入利多卡因4 mg·kg^(-1)前,鼻腔滴注右美托咪定2μg·kg^(-1);ND组雾化吸入利多卡因4 mg·kg^(-1)和右美托咪定2μg·kg^(-1),3组麻醉诱导和维持方法相同。采用改良耶鲁围术期焦虑量表(mYPAS)评价患儿检查前一日(T0)和入检查室后(T1)的焦虑程度,记录T1、麻醉诱导后(T2)、置镜时(T3)及清醒后(T4)患儿心率(HR)和平均动脉压(MAP)值,以及检查时间、咪达唑仑和利多卡因用量、加用丙泊酚例数以及不良反应发生情况。结果与C组比较,ID组和ND组T1时mYPAS评分、T1和T3时HR和MAP以及咪达唑仑用量均降低(P <0.05),ND组检查时间缩短[(32.7±6.3)min vs.(27.1±5.5)min, P <0.05],利多卡因用量[(7.1±2.2)mL vs.(4.2±1.3)mL]和加用丙泊酚例数(27%vs. 10%)均显著减少(P <0.05),中重度咳嗽(53%vs. 17%)、屏气(20%vs. 3%)、心动过速(47%vs.20%)和高血压(40%vs. 17%)的发生率均降低(P <0.05)。与ID组比较,ND组检查时间更短[(31.2±5.9)min vs.(27.1±5.5)min, P <0.05],咪达唑仑用量[(0.23±0.07) mg·kg^(-1) vs.(0.21±0.06) mg·kg^(-1)]和利多卡因用量[(6.3±1.9)mL vs.(4.2±1.3)mL]更少(P <0.05),中重度咳嗽发生率更低(43%vs.17%,P <0.05)。结论纤维支气管镜检查前雾化吸入右美托咪定可减轻患儿的焦虑,减少检查期间麻醉药物的应用,缩短检查时间,且安全。
AIM To investigate the effects of nebulized inhalation of dexmedetomidine on children undergoing fiberoptic bronchoscopy. METHODS Ninety children aged 3 to 7 years who underwent fiberoptic bronchoscopy were randomly divided into three groups. Group C received nebulized solution containing 4 mg·kg^(-1) of lidocaine before examination. Group ID was intranasally instilled with dexmedetomidine 2 μg·kg^(-1) before lidocaine inhalation. Group ND received nebulized solution containing 4 mg·kg^(-1) of lidocaine and 2 μg·kg^(-1) of dexmedetomidine before examination. The methods of induction and maintenance of anesthesia were the same in the three groups. The modified Yale perioperative anxiety scale(mYPAS) was used to evaluate the degree of anxiety of children on the day before the examination(T0) and after entering the examination room(T1). Changes in heart rate(HR) and mean arterial pressure(MAP) were recorded at T1, anesthesia induction(T2), endoscopy(T3) and after awake(T4). The amount of midazolam and lidocaine used during the operation, the time of the examination, the number of children who need to add propofol during operation and adverse reactions were recorded. RESULTS Compared with the group C, the mYPAS score at T1, HR and MAP at T1 and T3, and the dosage of midazolam in the ID group and ND group were significantly reduced(P < 0.05), and the examination time in the ND group was shortened((32.7±6.3) min vs.(27.1±5.5) min, P < 0.05), the amount of lidocaine((7.1±2.2) mL vs.(4.2±1.3) mL) and the number of cases with added propofol(27% vs. 10%) were significantly reduced(P < 0.05), the incidence of moderate to severe cough(53% vs. 17%), breath-hold(20% vs. 3%), tachycardia(47% vs. 20%) and hypertension(40% vs. 17%) were significantly decreased(P < 0.05). Compared with the group ID, the examination time of the ND group was shorter((31.2±5.9)min vs.(27.1±5.5) min, P < 0.05), the dosage of midazolam((0.23±0.07) mg· kg^(-1) vs.(0.21±0.06) mg·kg^(-1)) and lidocaine dosage((6.3±1.9)mL vs.(4.2±1.3)mL) were less(P < 0.05), and the incidence of moderate to severe cough was lower(43% vs. 17%, P < 0.05). CONCLUSION Nebulized inhalation of dexmedetomidine before fiberoptic bronchoscopy can reduce the anxiety of children, decrease the application of anesthetics during the examination, shorten the examination time, and is safe.
作者
冯毅
关静
贾玉涛
刘丹丹
马亚飞
FENG Yi;GUAN Jing;JIA Yu-tao;LIU Dan-dan;MA Ya-fei(The First Affiliated Hospital and College of Clinical Medicine of He-nan University of Science and Technology,Luoyang HE-NAN 471000,China)
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2021年第2期121-125,共5页
Chinese Journal of New Drugs and Clinical Remedies
