小剂量右美托咪定在小儿OSAHS扁桃体切除术全麻苏醒期的应用

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Abstract Objective To investigate the effect of small dose Dexmedetomidine in the recovery period of general anesthesia in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) tonsillectomy, and to provide reference for clinical selection of anesthesia program. Methods A total of 100 children with OSAHS who underwent tonsillectomy in Fuyang People’s Hospital, Anhui Province from January 2018 to December 2019 were selected as study subjects. According to the random number table method, they were divided into observation group (50 cases) and control group (50 cases). Children of two groups used the same anesthesia induction and maintenance plan. Control group was given 1 μg/kg Dexmedetomidine intraoperatively, and observation group was given 0.5 μg/kg Dexmedetomidine intraoperatively. Ramsay sedation score after extubation, postoperation visual analogue score (VAS), recovery and adverse reactions in the recovery period were compared between two groups. Results There were no significant differences in Ramsay sedation score after extubation and postoperation VAS score between two groups (P > 0.05). The respiratory recovery time, consciousness recovery time and extubation time in the recovery period in observation group were shorter than those in control group, and the differences were highly statistically significant (P < 0.01). The total incidence of adverse reactions in observation group was lower than that in control group in the recovery period, and the difference was statistically significant (P < 0.05). Conclusion Dexmedetomidine 0.5 μg/kg has good sedation and analgesia effect during the recovery period of general anesthesia after OSAHS tonsillectomy in children, and compared with 1.0 μg/kg Dexmedetomidine, patients have quicker recovery of respiration and consciousness, and fewer adverse reactions.

Key words： Obstructive sleep apnea-hypopnea syndrome Children Tonsillectomy Dexmedetomidine Small dose Recovery period

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	REN Rong1 DENG Haibo1 LI Zhen1 CAI Ning1 ZHANG Xinhai2

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REN Rong1 DENG Haibo1 LI Zhen1 CAI Ning1 ZHANG Xinhai2. Application of small dose Dexmedetomidine in the recovery period of general anesthesia in children with OSAHS tonsillectomy[J]. 中国医药导报, 2021, 18(28): 121-124.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I28/121

[1] 罗玲，王春.盐酸右美托咪定对小儿扁桃体、腺样体切除术中应激反应的影响[J].解放军医药杂志，2018，30（4）：100-103. DOI：10.3969/j.issn.2095-140X.2018.04.026.
[2] Bush B，Tobias JD，Lin C，et al. Postoperative bradycardia following adenotonsillectomy in children：Does intraoperative administration of dexmedetomidine play a role? [J]. Int J Pediatr Otorhinolaryngol，2018，104（27）：210-215. DOI：10.1016/j.ijporl.2017.11.025.
[3] 李清军，刘峰.右美托咪定对扁桃体摘除术患儿拔管反应及术后行为改变的影响[J].广西医科大学学报，2019， 36（7）：1112-1116. DOI：10.16190/j.cnki.45-1211/r.2019.07. 018.
[4] Chuanlai H，Rong F，Weifu L. Beneficial effects of dexm-edetomidine on early postoperative cognitive dysfunction in pediatric patients with tonsillectomy [J]. Exp Ther Med， 2018，17（29）：161-162. DOI：10.3892/etm.2018.6180.
[5] 侯慧艳，宋蕴安，顾洪斌，等.右美托咪定复合全凭静脉麻醉或全凭吸入麻醉对OSAHS患儿血流动力学影响的比较[J].国际麻醉学与复苏杂志，2019，40（3）：213-216. DOI:10.3760/cma.j.issn.1673-4378.2019.03.005.
[6] 诸福棠.实用儿科学[M].北京：人民卫生出版社，1985：99-108.
[7] 姚尚龙，于布为.小儿麻醉学[M].北京：人民卫生出版社，2006：200.
[8] 段世明，戴体俊，徐美英.麻醉药理学[M].北京：人民卫生出版社，2000：61-64.
[9] 王大柱，金熊元.小儿疼痛治疗[M].天津：天津科技出版社，1998：413-420.
[10] 黄庆先，王鹏.罗哌卡因联合右美托咪定局部浸润对扁桃体切除患儿术后疼痛的影响[J].儿科药学杂志，2018，24（9）：26-28. DOI:10.13407/j.cnki.jpp.1672-108X.2018.09.009.
[11] Tsiotou AG，Malisiova A，Kouptsova E，et al. Dexmedetomidine for the reduction of emergence delirium in children undergoing tonsillectomy with propofol anesthesia：A double-blind，randomized study [J]. Paediatr Anaesth，2018，28（7）：632. DOI：10.1111/pan.13397.
[12] 谢阳，姜文强，周蓦，等.不同剂量右美托咪定滴鼻对小儿气管插管拔除七氟烷半数有效浓度的影响[J].安徽医药，2019，23（12）：2510-2516.DOI:10.3969/j.issn.1009-6469.2019.12.045.
[13] Dehart AN，Potter J，Anderson J，et al. Perioperative interdisciplinary approach for reduction of opioid use in pediatric tonsillectomy：Protocol using dexmedetomidine and bupivicaine as adjunct agents [J]. Am J Otolaryngol，2019，31（8）：87-88. DOI：10.1016/j.amjoto.2019.02.007
[14] Saito J，Kimura F，Hashimoto H，et al. Usefulness of dexmedetomidine to prevent emergence agitation in a patient with Krabbe disease:a case report [J]. JA Clinical Reports，2018，17（1）：4. DOI：10.1186/s40981-018-0171-4.
[15] 邬冬云，王涛，陈秀侠，等.不同剂量右美托咪定滴鼻用于小儿术前镇静效果比较[J].国际麻醉学与复苏杂志，2020，41（5）：459-463.DOI:10.3760/cma.j.cn321761-20190429-00029.
[16] DeHart AN，Potter J，Anderson J，et al. Perioperative interdisciplinary approach for reduction of opioid use in pediatric tonsillectomy:Protocol using dexmedetomidine and bupivicaine as adjunct agents [J]. Am J Otolaryngol，2019，40（3）：382-388. DOI：10.1016/j.amjoto.2019.02.007.
[17] 王聪，李丽琴，张厚忠，等.麻醉诱导期右美托咪定滴鼻对氯胺酮静脉麻醉患儿躁动的影响[J].中国妇幼保健，2018，33（15）：3482-3484. DOI：10.7620/zgfybj.j.issn.1001-4411.2018.15.38.
[18] 谢照明.不同药物对小儿扁桃体腺样体切除术后镇静镇痛效果的比较[J].中外医学研究，2020，18（33）：54-57.
[19] 杨文，刘松，赵汝有，等.不同剂量右美托咪定对小儿扁桃体腺样体等离子切除术后镇痛和血流动力学的影响[J].中国医刊，2019，54（3）：331-334.DOI：10.3969/j.issn.1008-1070.2019.03.028.
[20] Franz AM，Dahl JP，Huang H，et al. The Development of an Opioid Sparing Anesthesia Protocol for Pediatric Ambulatory Tonsillectomy and Adenotonsillectomy Surgery-A Quality Improvement Project [J]. Paediatr Anaesth，2019，29（7）：129. DOI：10.1111/pan.13662.
[21] 郑文忠，陈培伟，颜学滔.术前经口腔黏膜喷雾不同剂量右美托咪定在小儿扁桃体腺样体切除术围麻醉期的效果对比[J].中国医药科学，2020，10（5）：186-189.
[22] 汪业铭，李树铁，袁明霞，等.不同剂量右美托咪定对小儿全麻苏醒期肌力恢复时间和躁动的影响[J].河北医药，2018，40（14）：2182-2185. DOI：10.3969/j.issn.1002-7386.2018.14.025.
[23] Capasso R，Rosa T，Tsou DY，et al. Variable Findings for Drug-Induced Sleep Endoscopy in Obstructive Sleep Apnea with Propofol versus Dexmedetomidine [J]. Otolaryngol Head Neck Surg，2017，154（4）：765-70. DOI:10.1177/0194599815625972.
[24] Trifa M，Tumin D，Tobias JD. Dexmedetomidine as an adjunct for caudal anesthesia and analgesia in children [J]. Minerva Anestesiol，2018，84（7）：836-847. DOI：10.23736/S0375-9393.18.12523-5.
[25] Boriosi JP，Eickhoff JC，Hollman GA. Safety and Efficacy of Buccal Dexmedetomidine for MRI Sedation in School-Aged Children [J]. Hosp Pediatr，2019，9（5）：348-354. DOI：10.1542/hpeds.2018-0162.
[26] 张辉，彭晓静，鄂慧良，等.不同剂量右美托咪定预防小儿扁桃体手术围术期麻醉术后躁动临床评价[J].中国药业，2020，29（14）：59-61. DOI:10.3969/j.issn.1006-4931. 2020.14.020.
[27] 匡荣.右旋美托咪定在小儿等离子刀扁桃体腺样体切除术中的应用[J].实用临床医药杂志，2018，22（9）：110-112. DOI:10.7619/jcmp.201809031.