右美托咪定联合咪达唑仑术前滴鼻在小儿斜疝手术中的麻醉效果

目的探究右美托咪定联合咪达唑仑术前滴鼻在小儿斜疝手术中的麻醉效果。 方法选取2016年1月至2018年11月，洪湖市人民医院就诊的156例斜疝患儿的临床资料，随机分为右美托咪定组（78例）和联合组（78例）。所有患儿均在术前30 min给予右美托咪定滴鼻，联合组患儿则加滴咪达唑仑。分别观测并比较2组患儿的生命体征指标、入睡时间、苏醒时间、镇静效果评分、疼痛评分、面罩接受率、躁动发生率和镇静满意程度。 结果滴鼻后10 min，2组患儿的心率（heart rate，HR）、血氧饱和度（pulse oxygen saturation，SpO₂）和呼吸频率（breathing rate，BR）比较，差异均无统计学意义（P>0.05）；滴鼻后30 min，2组患儿的HR、SpO₂、BR比较，差异均无统计学意义（P>0.05）。滴鼻后30 min与滴鼻后10 min，2组患儿组内HR、SpO₂、BR比较，差异均无统计学意义（P>0.05）。联合组患儿的入睡时间小于右美托咪定组，差异有统计学意义（P<0.05）；苏醒时间比较，差异无统计学意义（P>0.05）。联合组患儿的Ramsay镇静评分高于右美托咪定组、CHEOPS评分低于右美托咪定组，差异有统计学意义（P<0.05）。联合组的面罩接受率为92.307%，高于右美托咪定组的67.949%；镇静满意率为92.307%，高于右美托咪定组的71.795%；联合组的发生躁动率为5.128%，低于右美托咪定组的25.641%，差异均有统计学意义（P<0.05）。 结论右美托咪定联合咪达唑仑术前滴鼻在小儿斜疝手术中使用麻醉效果较好，起效快，可显著缩短患儿的入睡时间，产生良好的镇静、镇痛作用。

Anesthesia effect of dexmedetomidine combination with midazolam nasal drip before operation in children with indirect hernia

ObjectiveTo explore the anesthetic effect of dexmedetomidine combination with midazolam nasal drip in pediatric indirect hernia surgery. Methods156 children with indirect hernia treated in the general surgery in Honghu People's hospital from January 2016 to November 2018 were randomly divided into the dexmedetomidine group (78 cases) and the combination group (78 cases). All the children were given dexmedetomidine nasal drops 30 minutes before operation, while those in the combination group were added with midazolam. The vital signs, sleeping time, awakening time, the score of sedation effect, the score of CHEOPS, face mask acceptance rate, restlessness rate and sedation satisfaction were observed and compared between the two groups. ResultsThere was no significant difference in the levels of heart rate (HR), pulse oxygen saturation (SpO₂) and breathing rate (BR) between the two groups at 10 minutes after nasal drip and 30 minutes after nasal drip compared with before nasal drip, and 30 minutes after nasal drip compared with 10 minutes after nasal drip (P>0.05). The sleeping time in the combination group was shorter than that in the dexmedetomidine group (P<0.05), but there was no significant difference in the awakening time between the two groups (P>0.05). The score of Ramsay sedation in the combination group was higher than that in the dexmedetomidine group and the score of CHEOPS was lower than that in the dexmedetomidine group (P<0.05). The face mask acceptance rate in the combination group was 92.307%, higher than 67.949% of the dexmedetomidine group; the sedation satisfaction rate was 92.307%, higher than 71.795% of the dexmedetomidine group; the agitation rate in the combination group was 5.128%, lower than 25.641% of the dexmedetomidine group. There were significant differences in the three indicators between the two groups (P<0.05). ConclusionDexmedetomidine combination with midazolam nasal drip before operation in pediatric indirect hernia surgery has good anesthetic effect, quick onset, can significantly shorten the sleeping time of children, produce good sedative and analgesic effects, and is worthy of clinical promotion and application.