雾化吸入右美托咪定在儿童纤维支气管镜检查术前的应用

目的 探讨雾化吸入右美托咪定对行纤维支气管镜检查患儿的影响.方法 选取拟行纤维支气管镜检查患儿90例,随机分为3组,每组各30例.检查前C组雾化吸入利多卡因4mg·kg-1;ID组雾化吸入利多卡因4 mg·kg-1前,鼻腔滴注右美托咪定2 μg·kg-1;ND组雾化吸入利多卡因4 mg·kg-1和右美托咪定2μg·kg...

Application of nebulized inhalation of dexmedetomidine before fiberoptic bronchoscopy in children

AIM To investigate the effects of nebulized inhalation of dexmedetomidine on children undergoing fiberoptic bronchoscopy. METHODS Ninety children aged 3 to 7 years who underwent fiberoptic bronchoscopy were randomly divided into three groups. Group C received nebulized solution containing 4 mg·kg^-1 of lidocaine before examination. Group ID was intranasally instilled with dexmedetomidine 2 μg·kg^-1 before lidocaine inhalation. Group ND received nebulized solution containing 4 mg·kg^-1 of lidocaine and 2 μg·kg^-1 of dexmedetomidine before examination. The methods of induction and maintenance of anesthesia were the same in the three groups. The modified Yale perioperative anxiety scale(mYPAS) was used to evaluate the degree of anxiety of children on the day before the examination(T0) and after entering the examination room(T1). Changes in heart rate(HR) and mean arterial pressure(MAP) were recorded at T1, anesthesia induction(T2), endoscopy(T3) and after awake(T4). The amount of midazolam and lidocaine used during the operation, the time of the examination, the number of children who need to add propofol during operation and adverse reactions were recorded. RESULTS Compared with the group C, the mYPAS score at T1, HR and MAP at T1 and T3, and the dosage of midazolam in the ID group and ND group were significantly reduced(P < 0.05), and the examination time in the ND group was shortened((32.7±6.3) min vs.(27.1±5.5) min, P < 0.05), the amount of lidocaine((7.1±2.2) mL vs.(4.2±1.3) mL) and the number of cases with added propofol(27% vs. 10%) were significantly reduced(P < 0.05), the incidence of moderate to severe cough(53% vs. 17%), breath-hold(20% vs. 3%), tachycardia(47% vs. 20%) and hypertension(40% vs. 17%) were significantly decreased(P < 0.05). Compared with the group ID, the examination time of the ND group was shorter((31.2±5.9)min vs.(27.1±5.5) min, P < 0.05), the dosage of midazolam((0.23±0.07) mg· kg^-1 vs.(0.21±0.06) mg·kg^-1) and lidocaine dosage((6.3±1.9)mL vs.(4.2±1.3)mL) were less(P < 0.05), and the incidence of moderate to severe cough was lower(43% vs. 17%, P < 0.05). CONCLUSION Nebulized inhalation of dexmedetomidine before fiberoptic bronchoscopy can reduce the anxiety of children, decrease the application of anesthetics during the examination, shorten the examination time, and is safe.