摘要目的 观察右美托咪定术前滴鼻在小儿麻醉中的临床效果.方法 选取四川省人民医院温江分院2014年4月至2017年4月行包皮环切术患儿40例为研究对象,ASA Ⅰ级,年龄范围2～10岁,采用随机数字表法分为两组,术前30 min分别经鼻腔予右美托咪定1μg/kg(实验组)和等容量0.9％氯化钠注射液(对照组).记录给药前(T0)、滴鼻后5 min(T1)、滴鼻后10 min(T2)、滴鼻后20 min(T3)、滴鼻后30 min(T4)患儿心率、血氧饱和度、血压,给药30 min后评估患儿镇静评分,观察并记录术后清醒时的躁动评分.结果 重复测量方差分析结果显示:组间因素中,SBP(F=14.54、P＜0.05)和DBP(F=22.69、P＜0.05)差异有统计学意义;组内因素中SBP(F=13.77、P＜0.05)、DBP(F=10.48、P＜0.05)和HR(F =5.13、P＜0.05)存在交互作用,差异有统计学意义.与对照组相比,实验组各时间点心率、血压均低于对照组(P＜0.05),镇静评分优于对照组(t=-9.131,P＜0.05),术后躁动评分低于对照组(t=3.387,P＜0.05).结论 右美托咪定术前滴鼻能提供满意的镇静效果,不影响患儿的生命体征,并且显著降低全麻术后躁动的发生.

abstractsObjective To observe the clinical effects of preoperative intranasal dexmedetomidine in pediatric anesthesia.Methods From April 2014 to April 2017,40 pediatric patients who accepted elective circumcision,ASA Ⅰ,aged 2 to 10 years in Wenjiang Branch of Sichan Provincial People's Hospital were divided into two groups,with 20 cases in each group.The test group received intranasal dexmedetomidine 1 μg/kg,and the control group received intranasal equal volume of saline 30 min before surgery.HR,SpO2,BP were monitored and recorded before intranasal (T0),5min after intranasal (T1),10min after intranasal (T2),20min after intranasal (T3),30min after intranasal (T4).The sedation score was assessed after 30 min of administration.The restless score was observed after waking.Results ANOVA analysis showed that there were significant differences in SBP (F =14.54,P ＜ 0.05) and DBP (F =22.69,P ＜ 0.05) between the two groups,and the SBP (F =13.77,P ＜ 0.05),DBP (F =10.48,P ＜ 0.05),HR(F =5.13,P ＜ 0.05) had interaction effects.Compared with those of the control group,the heart rate and the diastolic pressure of the test group were decreased at T2 ～ T4 (all P ＜ 0.05).The sedation score of the test group was superior than that of the control group(t =-9.131,P ＜0.05),and the postoperative agitation score was lower than that of the control group (t =3.387,P ＜ 0.05).Conclusion Intranasal dexmedetomidine can provide satisfactory sedative effects without affecting the vital signs of children and significantly reducing the postoperative agitation.