[1]张红伟,王卫卫,李晓芳,等.右美托咪定对咽喉部手术鼾症儿童术后躁动及血流动力学的影响[J].新乡医学院学报,2021,38(8):730-733.[doi:10.7683/xxyxyxb.2021.08.006]
 ZHANG Hongwei,WAGN Weiwei,LI Xiaofang,et al.Effect of dexmedetomidine on postoperative agitation and hemodynamics of patients with snoring after throat surgery[J].Journal of Xinxiang Medical University,2021,38(8):730-733.[doi:10.7683/xxyxyxb.2021.08.006]
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右美托咪定对咽喉部手术鼾症儿童术后躁动及血流动力学的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年8
页码:
730-733
栏目:
临床研究
出版日期:
2021-08-05

文章信息/Info

Title:
Effect of dexmedetomidine on postoperative agitation and hemodynamics of patients with snoring after throat surgery
作者:
张红伟王卫卫李晓芳樊 腾张永强张江峰陈胜阳杨明月岳修勤
(新乡医学院第一附属医院麻醉科,河南 卫辉 453100)
Author(s):
ZHANG HongweiWAGN WeiweiLI XiaofangFAN TengZHANG YongqiangZHANG JiangfengCHEN ShengyangYANG MingyueYUE Xiuqin
(Department of Anesthesiology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
右美托咪定咽喉部手术血流动力学术后躁动
Keywords:
dexmedetomidinethroat surgeryhemodynamics academicpostoperative restlessness
分类号:
R726.1
DOI:
10.7683/xxyxyxb.2021.08.006
文献标志码:
A
摘要:
目的 探讨术前右美托咪定滴鼻对咽喉部手术鼾症儿童术后躁动及血流动力学的影响。方法 选择2019年1月至2019年9月于新乡医学院第一附属医院行咽喉部手术的62例鼾症儿童为研究对象,采用随机数字表法将患儿分为观察组和对照组,每组31例。麻醉诱导前30 min,观察组患儿给予1 μg·kg-1右美托咪定(8 μg·mL-1)滴鼻,对照组患儿给予等量生理盐水滴鼻。拔管后10 min,采用脸谱法评估患儿疼痛程度,小儿麻醉苏醒期躁动量化评分表评估患儿躁动情况;比较2组患儿麻醉开始时(T0)、手术开始时(T1)、拔管时(T2)的心率(HR)、平均动脉压(MAP)和经皮动脉血氧饱和度(SpO2)以及拔管时间、麻醉复苏室观察时间和术后不良反应。结果 观察组患儿术后躁动评分和疼痛评分显著低于对照组(P<0.05)。2组患儿术后拔管时间、麻醉复苏室观察时间比较差异无统计学意义(P>0.05)。2组患儿T0时HR、MAP显著低于T1、T2时(P<0.05);2组患儿T1时HR、MAP与T2时比较差异无统计学意义(P>0.05)T0、T1、T2时,观察组患儿HR、MAP显著低于对照组(P<0.05);2组患儿各时间点SpO2比较差异均无统计学意义(P>0.05)。对照组患儿发生鼻咽出血1例,恶心6例;观察组患儿未发现明显不良反应。结论 术前右美托咪定滴鼻可降低儿童咽喉部手术术后躁动率和疼痛,维持血流动力学稳定,无明显不良反应。
Abstract:
Objective To investigate the effect of dexmedetomidine by nasal dropping before surgery on postoperative restlessness and hemodynamics of children with snoring after throat surgery. Methods A total of 62 children with snoring underwent throat surgery in the First Affiliated Hospital of Xinxiang Medical University from January 2019 to September 2019 were selected as research subjects,and they were divided into the observation group and control group according to random number table,with 31 cases in each group.Thirty minutes before induction of anesthesia,the children in the observation group were given 1 μg·kg-1 dexmedetomidine (8 μg·mL-1) by nasal dropping,the children in the control group were given the same amount of normal saline by nasal dropping.Ten minutes after extubation,the pain degree of patients was evaluated by facebook method,the pediatric anesthesia emergence delirium scale was used to evaluate the agitation of patients.The heart rate(HR),mean arterial pressure(MAP),percutaneous arterial oxygen saturation(SpO2)at the beginning of anesthesia(T0),beginning of operation(T1) and time of extubation(T2) were compared between the two groups,the time of extubation and the time of observation in postanesthesia care unit(PACU),and postoperative adverse reactions between the two groups were compared.Results The postoperative restlessness score and pain score of the children in the observation group were significantly lower than those in the control group (P<0.05),there was no statistically significant difference in the time of extubation and time of observation in PACU between the two groups (P>0.05).At T0,the HR and MAP were significantly lower than those at T1 and T2 in the two groups (P<0.05),there was no significant difference in HR and MAP at T1 and T2 in the two groups (P>0.05),the HR and MAP of children in the observation group was significantly lower than those in the control group at T0,T1 and T2(P<0.05),there was no significant difference in SpO2 between the two groups at every time point(P>0.05).In the control group,one case had nasopharyngeal hemorrhage and six cases had nauseano obvious adverse reaction was found in the observation group.Conclusion Preoperative nasal drops of dexmedetomidine can reduce the postoperative agitation and analgesic of children with laryngopharyngeal surgery,their hemodynamics are stable,and they have no obvious adverse reactions.

参考文献/References:

[1] 周成勇,孙宝春,王丰,等.低温等离子辅助下儿童腺样体和扁桃体手术临床疗效观察[J].临床耳鼻咽喉头颈外科杂志,2016,30(11):863-866.
[2] 李亮,沈蓓.儿童扁桃体腺样体低温等离子射频消融术后出血特点分析及应对策略[J].中国耳鼻咽喉头颈外科,2016,23(6):309-312.
[3] 王鹏,蔡捍东,赵志丹,等.BIS监测下不同剂量右美托咪定用于剖宫产手术镇静的效果观察[J].中国医刊,2017,52(6):93-96.
[4] 陈金华,丁锦萍,靳红绪,等.右美托咪定对扁桃体及腺样体切除术后患儿苏醒期躁动的影响[J].山西医药杂志,2016,45(20):2397-2399.
[5] 高龙飞,高昌俊,韩瑞丽,等.右美托咪定滴鼻对小儿扁桃体腺样体切除术苏醒期躁动及血流动力学的影响[J].现代生物医学进展,2017,17(20):3855-3859
[6] 王险峰,李亚明.右美托咪定对小儿扁桃体腺样体切除术麻醉苏醒期躁动及拔管反应的影响[J].安徽医药,2017,21(7):1317-1321.
[7] TROSMAN I.Childhood obstructive sleep apnea syndrome:a review of the 2012 american academy of pediatrics guidelines[J].Pediatr Ann,2013,42(10):195-199.
[8] 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版) 写作组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)[J].中国呼吸与危重监护杂志,2015,14(4):398-405.
[9] 陈妙儿.腺样体肥大的临床非手术治疗疗效[J].实用医学杂志,2015,31(13):2199-2201.
[10] ITO E,INOUE Y.The International Classification of Sleep Disorders,third edition.American Academy of Sleep Medicine.Includes bibliographies and index[J].Nihon Rinsho,2015,73(6):916-923.
[11] CAI X,ZHANG P,LU S,et al.Effects of intraoperative dexmedetomidine on postoperative pain in highly nicotinedependent patients after thoracic surgery[J].Medicine (Baltimore),2016,95(22):e3814.
[12] HENDERSON B,TABONA P,POOLE S,et al.Cloning and espreession of the Actinobacillus actinomycetemcomitans thioredoxin(trx) gene and assessment of cytokine inhibitory activity[J].Infect Immun,2001,69(1)154-258.
[13] 郑凌,朱崇军.右美托咪定麻醉对小儿血流动力学、苏醒期躁动、疼痛程度的影响[J].使用临床医药杂志,2020,24(11):62-64.
[14] TANG G J.Similarity and synergy of tranma and sepsisrole of tumor necrosis factor-alpha and interleuin-6[J].Acta Anaesthesiol Sn,1996,34(3):141-149.
[15] LEE Y S,KIM W Y,CHOI J H,et al.The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia[J].Korean J Anesthesiol,2010,58(5):440-445.
[16] 谢阳,姜文强,周蓦,等.不同剂量右美托咪定滴鼻对小儿气管插管拔除七氟烷半数有效浓度的影响[J].安徽医药,2019,23(12):2510-2516.
[17] MASON K P,LUBISCH N B,ROBINSON F,et al.Intramuscular dexmedetomidine sedation for pediatric MRI and CT[J].AJR Am J Roentgenol,2011,197(3):720-725.
[18] 黎平,闵苏,王萍,等.右美托咪定或丙泊酚复合瑞芬太尼用于功能神经外科术中唤醒的比较[J].临床麻醉学杂志,2011,27(8):755-757.
[19] 陈仲群,郭绪坚.右美托咪定在硬膜外麻醉术中的镇静作用[J].广东医学,2011,32(12):1614-1615.
[20] LI A,YUEN V M,GOULAY-DUFA S,et al.Pharmacokinetic and pharmacodynamic study of intranasal and intravenous dexmedetomidine[J].Br J Anaesth,2018,120(5):960-968.
[21] YANG F,LIU Y,YU Q,et al.Analysis of 17 948 pediatric patients undergoing procedural sedation with a combination of intranasal dexmedetomidine and ketamine[J].Paediatr Anaesth,2019,29(1):85-91.
[22] 孙志强,李蒙蒙,纪淑敏,等.右美托咪定滴鼻用于小儿腹腔镜疝囊高位结扎术的临床观察[J].同济大学学报(医学版),2020,41(6):779-783
[23] 郝静,吴浩,马正良,等.右美托咪定对后腹腔镜手术患者术中血流动力学的影响[J].中国微创外科杂志,2011,11(30):215-219.

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更新日期/Last Update: 2021-08-05