右美托咪定滴鼻应用于小儿唇腭裂手术的效果研究
Effects of intranasal dexmedetomidine for children undergoing cleft lip and palate repair surgery

摘要： 目的 观察唇腭裂患儿术前经鼻滴入右美托咪定对术前紧张情绪、父母分离焦虑、面罩接受程度和术后躁动的影响。方法 选择行唇腭裂修复术患儿120例，年龄6月~3岁，随机分为2组：A组术前30 min经鼻滴入生理盐水 0.02 mL·kg-1，B组滴入右美托咪定2 μg·kg-1。观察和记录患儿入睡时间、术前镇静评分、分离焦虑评分、面罩吸入诱导接受度评分和术后躁动评分。结果 B组患儿入睡时间为（10.52±5.34）min。在给药后30 min的镇静评分、与父母的分离焦虑评分、面罩接受程度评分、术后躁动评分中，B组明显优于A组，差异有统计学意义（P<0.05）。结论 唇腭裂患儿术前经鼻滴入右美托咪定，可以产生良好的术前镇静作用，改善与父母的分离焦虑，提高面罩接受度，并可显著抑制术后躁动。
Abstract: Objective To observe the preoperative sedation and postoperative agitation effects of intranasal dexmedetomidine premedication on children undergoing cleft lip or palate repair surgery. Methods One hundred and twenty children aged 6 months to 3 years old undergoing elective cleft lip or palate repair surgery were randomly allocated into two groups. Thirty minutes before operation, patients in group A received intranasal placebo(0.9% saline) 0.02 mL·kg-1. Patients in group B received intranasal dexmedetomidine 2 μg·kg-1. The children’s time for falling asleep was observed. The preoperative sedation score, the profile of mood state apart from parents, the receipt score of face mask for anesthesia induction and the postoperative agitation score were evaluated. Results The time for children in group B in falling asleep was (10.52±5.34) min. The preoperative sedation score, the profile of mood state apart from parents, the receipt score of face mask and the postoperative agitation in group B were better than group A(P<0.05). Conclusion Premedication with intranasal dexmedetomidine 2 μg·kg-1 for children undergoing cleft lip or palate repair surgery produces good preoperative sedation and postoperative agitation effects