CAJ | 학술논문

目的比较右美托咪定和咪达唑仑鼻腔给药用于神经外科手术患儿术前镇静的效果.方法择期行开颅手术患儿40例,年龄2～7岁,体重11～26 kg,性别不限,ASA分级Ⅱ级.采用随机数字表法,将患儿分为2组(n=20):咪达唑仑组(M组)和右美托咪定组(D组).于术前准备室分别鼻腔给予咪达唑仑0.2 mg/kg或右美托咪定2μg/kg.给药后30 min时与父母分离,人手术室面罩吸氧,同时行静脉穿刺.记录鼻粘膜刺激反应发生情况和与父母分离情况;记录与父母分离时的Ramsay镇静评分.记录给药后至静脉穿刺期间心动过缓、低血压、高血压和低氧血症等的发生情况.结果 2组患儿均成功与父母分离.与M组比较,D组鼻粘膜刺激反应发生率降低,Ramsay镇静评分升高(P＜0.05).2组患儿均未见心动过缓、低血压、高血压和低氧血症等不良反应的发生.结论右美托咪定鼻腔给药用于神经外科手术患儿术前镇静的效果优于咪达唑仑.
목적 비교우미탁미정화미체서륜비강급약용우신경외과수술환인술전진정적효과.방법 택기행개로수술환인40례,년령2～7세,체중11～26 kg,성별불한,ASA분급Ⅱ급.채용수궤수자표법,장환인분위2조(n=20):미체서륜조(M조)화우미탁미정조(D조).우술전준비실분별비강급여미체서륜0.2 mg/kg혹우미탁미정2μg/kg.급약후30 min시여부모분리,인수술실면조흡양,동시행정맥천자.기록비점막자격반응발생정황화여부모분리정황;기록여부모분리시적Ramsay진정평분.기록급약후지정맥천자기간심동과완、저혈압、고혈압화저양혈증등적발생정황.결과 2조환인균성공여부모분리.여M조비교,D조비점막자격반응발생솔강저,Ramsay진정평분승고(P＜0.05).2조환인균미견심동과완、저혈압、고혈압화저양혈증등불량반응적발생.결론 우미탁미정비강급약용우신경외과수술환인술전진정적효과우우미체서륜.
Objective To compare the dexmedetomidine and midazolam administered intranasally for preoperative sedation in the pediatric patients undergoing neurosurgical procedures.Methods Forty pediatric patients of both sexes, aged 2-7 yr, weighing 1 1-26 kg, of American Society of Anesthesiology Anesthesiologists physical status Ⅱ, were equally and randomly assigned into either midazolam group (group M) and dexmedetomidine group (group D).Group M received midazolam 0.2 mg/kg administered intranasally, and group D received dexmedetomidine 2 μg/kg administered intranasally in the room for preoperative preparation.The pediatric patients were separated from their patients at 30 min after administration.Oxygen was inhaled by mask after admission to the operating room, and venipuncture was performed.The responses to nasal mucous membrane irritation and separation from their parents were recorded.Ramsay sedation scores were recorded when the patients were separated from their parents.The occurrence of bradycardia, hypotension, hypertension and hyoxemia was recorded from the end of administration until venipuncture.Results The pediatric patients were successfully separated from their patients in the two groups.Compared with group M, the incidence of responses to nasal mucous membrane irritation was significantly decreased, and Ramsay sedation scores were increased in group D (P＜0.05).No pediatric patients developed adverse reactions such as bradycardia, hypotension, hypertension and hyoxemia in the two groups.Conclusion Dexmedetomidine administered intranasally provides better efficacy than midazolam when used for preoperative sedation in the pediatric patients undergoing neurosurgical procedures.