不同年龄对儿童腹股沟疝手术应用右旋美托咪啶镇静效果的影响

目的：探讨不同年龄腹股沟疝患儿应用右旋美托咪啶的镇静效果。方法以本院2013年1月—2015年10月择期行单侧腹股沟疝手术的60例患儿为研究对象，其中1~4岁患儿35例，计为 A 组，5~8岁25例，计为 B组，均给予经鼻滴入右旋美托咪啶2μg / kg 干预，比较两组患儿用药前（T0）、用药后10 min（T1）、用药后20 min（T2）、用药后30 min（T3）、术毕（T4）不同时间点血流动力学、警觉/镇静（ OAA / S）评分及 Ramsay 评分情况，同时记录不同年龄患儿平均镇静起效时间及术毕苏醒时间。结果不同时间点两组患者心率、平均动脉压（ MAP）比较差异均无统计学意义（P ﹥0.05）。两组 T1、T2、T3时 OAA / S 评分较 T0均明显下降，Ramsay 评分较 T0均明显上升（P ﹤0.05）。B组 T3时 OAA / S 评分低于 A 组，且 Ramsay 评分高于 A 组（P ﹤0.05）。两组平均镇静起效时间及术毕苏醒时间比较差异无统计学意义（P ﹥0.05）。所有患儿均无呼吸抑制、恶心呕吐、便秘等不良反应发生。结论右旋美托咪啶经鼻滴入2μg / kg 能有效维持所有腹股沟疝患儿血流动力学稳定，镇静效果良好，且5~8岁患儿镇静效果明显。

Effect of Different Ages on Sedative Effectiveness of Dexmedetomidine in Children with Inguinal Hernia by Sur-gical Treatment

Objective To investigate sedative effects of Dexmedetomidine on different ages children with ingui-nal hernia. Methods A total of 60 children undergoing unilateral inguinal hernia during January 2013 and October 2015 were recruited in this study. The children were divided into group A(1-4 years old,n = 35)and group B(5-25 years old,n = 25),and were intervened with 2 μg / kg Dexmedetomidine by transnasal drip. Hemodynamics,observerˊs assess-ment of alertness / sedation(OAA / S)score and Ramsay score were compared before medication(T0),at 10th min after medication(T1),20th min after medication(T2),30th min after medication(T3)and at the end of operation(T4)in two groups. Meanwhile,the average time of onset time and palinesthesia time after operation in different age groups were recorded. Results There were no significant differences in heart rate(HR)and mean arterial blood pressure(MAP)in two groups at different time points(P ﹥ 0. 05). OAA / S scores at T1,T2 and T3 were significantly lower than those at T0,while Ramsay scores were significantly higher than those at T0 in two groups(P ﹤ 0. 05). OAA / S score at T3 was lower,while Ramsay score was higher in group B than those in group A( P ﹤ 0. 05). There were no significant differ-ences in average time of onset and recovery time after operation in two groups(P ﹥ 0. 05). No adverse reactions such as respiratory depression,nausea and vomiting and constipation were found in any children. Conclusion Transnasal drip of Dexmedetomidine 2 μg / kg can effectively maintain hemodynamics stability with good sedative effect for children with in-guinal hernia,and sedative effect in 5-8 year-old children is obvious.