右美托咪定滴鼻和七氟烷吸入对患儿麻醉前镇静和 苏醒后躁动的影响

目的 探究在麻醉准备室中右美托咪定滴鼻和七氟烷面罩吸入对患儿开静脉及入手术室诱导时的镇静程度和苏醒后躁动的影响。方法 选择择期手术患儿60例，随机分为D组和S组，每组30例。D组于麻醉准备室予右美托咪定2 μg/kg滴鼻，S组患儿于麻醉准备室予8%七氟烷面罩吸入。两组患儿均于麻醉准备室开放静脉，入手术室后以相同麻醉方式诱导，术中吸2%~3%七氟醚维持。记录患儿开放静脉和麻醉诱导时的镇静评分、麻醉过程中HR、MAP变化、拔管时间和躁动评分。结果 两组患儿于麻醉开放静脉时镇静评分相比，差异无统计学意义（P＞0.05）；与S组比较，D组诱导时的镇静程度更好、麻醉恢复期躁动发生率更低（P＜0.05），但两组患者麻醉拔管时间相比，差异无统计学意义（P＞0.05）。麻醉过程中，D 组的HR、MAP均低于S组，差异有统计学意义（P＜0.05）。结论 麻醉准备室中右美托咪定滴鼻及七氟烷面罩吸入均能有效缓解患儿术前焦虑恐惧，有利于静脉通路的顺利开放。其中右美托咪定滴鼻的患儿入手术室诱导时镇静效果更好、术中血流动力学更平稳，苏醒期躁动的发生率更低，有利麻醉管理。

Effects of Dexmedetomidine Dripping and Seven Halothane Inhalation on Sedation and Recovery Agitation after Anesthesia in Children

Abstract:Objective To explore the degree of sedation and the effect of restlessness after awakening in children with the inhalation of dexmedetomidin nose drops and seven halothane mask in the anesthesia preparation room.Methods 60 children with elective surgery were randomly divided into group D and group S,30 cases in each group.Group D was given dexmedetomidine 2μg/kg in the anesthesia preparation room.Group S received inhalation of 8% seven halothane mask in the anesthesia preparation room.Two groups of children were opened in the anesthesia preparation room.After entering the operation room,they were induced by the same anesthetic method,and 2%~3% sevoflurane was maintained during the operation.The sedation score,HR and MAP changes,extubation time and restlessness score were recorded during open heart and anesthesia induction.Results There was no significant difference in sedation score between the two groups in open vein anesthesia(P>0.05),the sedation degree of group D was better than that in group S, and the incidence of restlessness in recovery period of anesthesia was lower than that in group S(P<0.05),However,there was no significant difference in the time of anesthesia extubation between the two groups(P>0.05).During anesthesia,the HR and MAP in group D were lower than those in group S,the difference was statistically significant(P<0.05).Conclusion The inhalation of dexmedetomidin and seven halothane mask in the preparation room can effectively relieve the anxiety and fear of the children,which is beneficial to the smooth opening of the venous access.The incidence of agitation is lower,and it is beneficial to the management of anesthesia.