Li Hongyan, Zhang Longming, Shi Min, Yang Shengqiang, Li Shengde, Gao Shenqiang
J Perianesth Nurs. 2018 Feb;33(1):53-57. doi: 10.1016/j.jopan.2016.03.005. Epub 2017 Feb 24.
This study aims to investigate the impacts of dexmedetomidine (DEX) on agitation in the postanesthesia care unit (PACU) for pediatric patients undergoing tonsillectomy.
Eighty-two pediatric patients with elective tonsillectomy were randomly divided into the DEX group (group D) and the control group (group C). All patients' surgery in the two study groups were completed under tracheal cannula-based general anesthesia. Group D was infused 0.2 mcg/kg/hour DEX. The operation time, extubation time, PACU time, number of cases with nausea and vomiting, hemodynamic changes, and doses of rescue fentanyl, as well as every 10-minute observational pain scoring, and emergence agitation score in PACU, of the two groups were recorded.
Chi-square and Fischer exact tests were applied for categorical variables.
The maximum observational pain scoring and emergence agitation score of group D at 0, 10, and 20 minutes in PACU were significantly lower than group C (P < .01); the rescue doses of fentanyl and incidence of severe agitation in PACU in group D were significantly reduced than group C (P < .01). Group D showed significantly less cases with nausea and vomiting than group C (P < .05).
Low-dose DEX could significantly reduce the delirium and agitation in the PACU stage of pediatric tonsillectomy, and there were no untoward hemodynamic events in this study of 80 patients.
本研究旨在探讨右美托咪定（DEX）对接受扁桃体切除术的儿科患者在麻醉后监护病房（PACU）中的躁动影响。
82例择期扁桃体切除术的儿科患者被随机分为DEX组（D组）和对照组（C组）。两个研究组的所有患者手术均在气管插管全身麻醉下完成。D组静脉输注0.2 mcg/kg/小时的DEX。记录两组患者的手术时间、拔管时间、PACU停留时间、恶心呕吐病例数、血流动力学变化、抢救用芬太尼剂量，以及每10分钟的观察性疼痛评分和PACU中的苏醒期躁动评分。
分类变量采用卡方检验和Fisher精确检验。
D组在PACU中0、10和20分钟时的最大观察性疼痛评分和苏醒期躁动评分显著低于C组（P <.01）；D组PACU中芬太尼的抢救剂量和严重躁动发生率显著低于C组（P <.01）。D组恶心呕吐病例明显少于C组（P <.05）。
低剂量DEX可显著降低小儿扁桃体切除术后PACU阶段的谵妄和躁动，本研究中80例患者未发生不良血流动力学事件。
