摘要
目的:探讨右美托咪定与氢吗啡酮复合滴鼻在小儿腺样体手术术前母婴分离过程中的麻醉镇静效果。方法:选取我院2021年1月-2022年8月择期行腺样体手术患儿60例,采用随机数表法分为观察组和对照组各30例,观察组采用1.5μg/kg右美托咪定复合30μg/kg氢吗啡酮滴鼻术前镇静,对照组采用1.5μg/kg右美托咪定滴鼻术前镇静。比较两组患儿滴鼻前(T0)、滴鼻后5 min(T1)、15 min(T2)、25 min(T3)各时间点镇静程度(RASS)评分,母婴分离时(T4)的镇静情绪评分,开放静脉时(T5)的睡眠障碍量表(ESS)评分及各时间点脉搏氧饱和度(SpO_(2))和心率(HR)的变化,全麻诱导期扣面罩接受程度评分,苏醒期躁动评分以及术后不良反应发生情况等。结果:T1~T3时间点RASS评分、T5时间点ESS评分、苏醒期躁动评分,观察组均低于对照组(P<0.05);T4时间点镇静情绪评分、诱导期扣面罩接受程度评分,观察组均高于对照组(P<0.05);惊醒哭闹患儿例数和需辅助麻醉患儿例数,观察组少于对照组(P<0.05);两组患儿T0~T5时间点HR、SpO_(2)水平变化均不显著(P>0.05);两组患儿不良反应发生率比较差异均无统计学意义(P>0.05)。结论:右美托咪定复合氢吗啡酮术前滴鼻,安全有效,利于腺样体手术患儿与父母安静分离,不良反应少,值得进一步推广应用。
Objective:To probe into the anesthetic and sedative effects of dexmedetomidine combined with hydromorphone nasal drip in sedation of mother-infant separation before adenoidectomy.Methods:From Jan.2021 to Aug.2022,60 children undergoing elective adenoidectomy were selected to be divided into the observation group and control group via the random number table method,with 30 cases in each group.The observation group received 1.5 μg/kg dexmedetomidine combined with 30 μg/kg hydromorphone nasal drip before surgery,and the control group was given 1.5 μg/kg dexmedetomidine nasal drop before surgery.The Richmond Agitation and Sedation Scale(RASS) scores of two groups were compared before(T0),5 min after nasal drops(T1),15 min after nasal drops(T2),and 25 min after nasal drops(T3),as well as the sedation emotion score at mother-infant separation(T4),Epworth Sleepiness Scale(ESS) at vein opening(T5),and changes in pulse oxygen saturation(SpO_(2)) and heart rate(HR) at various time points.Furthermore,the mask acceptance score during general anesthesia induction,agitation scores during recovery,and postoperative adverse drug reactions were compared.Results:The RASS scores at T1 to T3,ESS at T5 and agitation score during recovery in the observation group were significantly lower than those in the control group(P<0.05).The sedation emotion score at T4 and the mask acceptance score during general anesthesia induction in the observation group were significantly higher than those in the control group(P<0.05).The number of children who woke up and cried,the number of children who needed assisted anesthesia in the observation group were significantly less than those in the control group(P<0.05).There was no significant difference in the changes of HR and SpO_(2) at T0 to T5 between two groups(P>0.05).The incidence of adverse drug reactions between two groups was not statistically significant(P>0.05).Conclusion:Dexmedetomidine combined with hydromorphone preoperative nasal drops is safe and effective,facilitates quiet separation of children undergoing adenoidectomy from their parents,and has few adverse drug reactions,and deserves further application.
作者
李长松
李云祥
李小静
孙灿林
姜琳
Li Changsong;Li Yunxiang;Li Xiaojing;Sun Canlin;Jiang Lin(Jiangsu Taizhou People’s Hospital,Jiangsu Taizhou 225300,China)
出处
《儿科药学杂志》
CAS
2024年第2期31-35,共5页
Journal of Pediatric Pharmacy
基金
江苏省妇幼健康科研重点资助项目,编号F202024。
关键词
右美托咪定
氢吗啡酮
儿童
术前滴鼻镇静
母婴分离
dexmetomidine
hydromorphone
children
preoperative nasal sedation
mother-infant separation
