摘要
目的探讨盐酸右美托咪定在整形外科小儿面部外伤急诊局麻手术中的作用及安全性。方法选择2019年5月—2019年11月收治的急诊面部外伤的患儿100例作为研究对象,以随机数字表分为观察组和对照组,每组50例。观察组在常规护理基础上在进入手术室前20 min经鼻滴入盐酸右美托咪定2μg/kg,然后带入手术室在局部麻醉下行面部外伤清创缝合术,对照组行常规护理后进入手术室在局部麻醉下清创缝合。结果两组患儿心率(HR)、平均动脉压(MAP)波动均在正常范围;观察组患儿在疼痛刺激明显时刻血流动力学变化低于对照组(P<0.05);在麻醉前、麻醉时、手术开始时及术后4个时间段记录并评价患儿躁动发生率,观察组患儿躁动发生率低于对照组(P<0.05)。结论面部急诊外伤患儿术前应用盐酸右美托咪定超前镇静可降低躁动的发生率,减少患儿对疼痛等不良刺激的反应,无明显不良反应,值得临床推广。
Objective To evaluate the role and safety of dexmedetomidine hydrochloride in local anesthesia for facial trauma in orthopedic surgery. Methods 100 children with emergency facial trauma from May 2019 to November 2019 in our department were selected as observation subjects. The random number table was divided into experimental group and control group, 50 cases in each group. The observation group entered the operation. 20 minutes before the chamber, dexmedetomidine hydrochloride 2 μg/kg was instilled into the operating room and the facial trauma was debrided and sutured under local anesthesia. The control group took the psychological care and distracted attention to the child. In the operating room, debridement and suture under local anesthesia. Results The heart rate(HR) and mean arterial pressure(MAP) of the two groups were in the normal range. The hemodynamic changes in the observation group were significantly lower than those in the control group(P<0.05). Before anesthesia, The incidence of agitation was recorded and evaluated during anesthesia, at the beginning of surgery, and at 4 postoperatively. The incidence of agitation in the observation group was lower than that in the control group(P<0.05). Conclusions Preoperative sedation with dexmedetomidine hydrochloride in children with facial emergency trauma can reduce the occurrence of agitation and reduce the response of children to adverse stimuli such as pain. There is no obvious adverse reaction and it is worthy of promotion.
作者
游琳
邹彦龙
李娅萍
徐克平
YOU Lin;ZOU Yanlong;LI Yaping;XU Keping(Department of Plastic Surgery,the First Affiliated Hospital of Army Military Medical University,Chongqing 400038,China)
关键词
盐酸右美
小儿急诊外伤
躁动
超前镇静
整形美容
Dexame hydrochloride
Pediatric emergency trauma
Agitation
Advanced sedation
Plastic surgery
