Chen Chaoqiao, You Minji, Li ZhangLiang, Nie Li, Zhao Yune, Chen Gang
Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China.
The Eye Hospital of WenZhou Medical University, Wenzhou 325000, China.
J Ophthalmol. 2019 Apr 8;2019:2560453. doi: 10.1155/2019/2560453. eCollection 2019.
To investigate the feasibility and safety of higher-dose dexmedetomidine in ophthalmological outpatient examination of children with cataract.
100 cases of children were recruited in the study and randomly equally divided into two groups. One group was given 2 g/kg intranasal dexmedetomidine anesthesia, while the other group was under 3 g/kg. The dosage of dexmedetomidine was calculated by the same anesthesiologist according to the weight of patient. After sufficient sedation, the same ophthalmologist performed ocular examinations manually, including intraocular pressure, keratometry, axial length, and corneal thickness and recorded the ocular position score during intraocular pressure measurement and corneal thickness measurement. Other variables were sedation onset time, recovery time, vital signs, and side effects.
In intraocular pressure measurement, only one case in the 2 g/kg group did not complete the examination, while all cases in the 3 g/kg group completed the examination and the difference of the success rate between the two groups was nonsignificant ( > 0.05). The success rates of the 3 g/kg group in corneal curvature, axial length, and corneal thickness examination were 96%, 92%, and 86%, respectively, which were significantly higher than those of the 2 g/kg group (22%, 18%, and 4%). The average onset time of sedation in the 3 g/kg group was 15.42 ± 2.09 minutes, which was significantly shorter than that in the 2 g/kg group (19.52 ± 2.43 minutes, < 0.001). The average time of completing all examinations in the 3 g/kg group was 18.36 ± 4.01 minutes, which was significantly shorter than that in the 2 g/kg group (22.62 ± 4.13 min, < 0.001). The recovery time of group 3 g/kg was 90.62 ± 27.80 min, which was significantly longer than that of group 2 g/kg (49.20 ± 15.50 min). Vital signs such as pulse, blood pressure, oxygen saturation, and heart rate kept in normal range throughout the tests, and no obvious side effects were observed.
3 g/kg intranasal dexmedetomidine had a higher sedation success rate and quality than 2 g/kg did in pediatric ocular examinations, without any obvious side effects.
探讨高剂量右美托咪定用于儿童白内障眼科门诊检查的可行性及安全性。
选取100例儿童纳入本研究，随机等分为两组。一组给予2μg/kg鼻内右美托咪定麻醉，另一组给予3μg/kg。右美托咪定剂量由同一位麻醉医生根据患者体重计算。充分镇静后，由同一位眼科医生进行眼部手动检查，包括眼压、角膜曲率测量、眼轴长度及角膜厚度测量，并记录眼压测量和角膜厚度测量期间的眼位评分。其他变量包括镇静起效时间、恢复时间、生命体征及副作用。
眼压测量时，2μg/kg组仅1例未完成检查，而3μg/kg组所有病例均完成检查，两组成功率差异无统计学意义（P>0.05）。3μg/kg组角膜曲率、眼轴长度及角膜厚度检查的成功率分别为96%、92%和86%，显著高于2μg/kg组（分别为22%、18%和4%）。3μg/kg组镇静平均起效时间为15.42±2.09分钟，显著短于2μg/kg组（19.�2±2.43分钟，P<0.001）。3μg/kg组完成所有检查的平均时间为18.36±4.01分钟，显著短于2μg/kg组（22.62±4.13分钟，P<0.001）。3μg/kg组恢复时间为90.62±27.80分钟，显著长于2μg/kg组（49.20±15.50分钟）。整个检查过程中脉搏、血压、血氧饱和度及心率等生命体征均保持在正常范围，未观察到明显副作用。
在儿童眼科检查中，3μg/kg鼻内右美托咪定的镇静成功率及质量高于2μg/kg，且无明显副作用。
