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鼻腔内给予右美托咪定与口服咪达唑仑用于全麻下小儿牙科患者术前用药的比较:一项随机临床试验。

Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Dental Patients under General Anesthesia: A Randomised Clinical Trial.

机构信息

The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laoratory of Oral Biomedicine Ministry of Education, Wuhan University, Wuhan, Hubei 430079, China.

Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei 430079, China.

出版信息

Biomed Res Int. 2020 Apr 24;2020:5142913. doi: 10.1155/2020/5142913. eCollection 2020.

Abstract

The aim of this study was to compare the effects of preoperative intranasal dexmedetomidine and oral midazolam on preoperative sedation and postoperative agitation in pediatric dentistry. A total of 60 children (ASA grade I, aged 3-6 years) scheduled for elective pediatric dental treatment were randomly divided into the dexmedetomidine (DEX) and midazolam (MID) groups. Ramsay sedation score, parental separation anxiety scale, mask acceptance scale, pediatric anesthesia emergence delirium scale, and hemodynamic parameters were recorded. The Ramsay sedation scale and hemodynamic parameters of the children were observed and recorded immediately before administration and 10, 20, and 30 min after administration. A satisfactory mask acceptance scale rate was 93.33% in both MID and DEX groups, and there was no significant difference between the two groups ( > 0.05). The proportions of children that "successfully separated from their parents" were 93.33% (MID) and 96.67% (DEX). No significant difference was found between the two groups ( > 0.05). The incidence of agitation was 20% in the MID group and 0% in the DEX group, and the difference was statistically significant ( < 0.05). Intranasal dexmedetomidine and oral midazolam provided satisfactory sedation. No significant difference between the two groups was found in terms of parental separation anxiety and mask acceptance ( > 0.05). The incidence of postoperative pediatrics emergence delirium was significantly lower in the DEX group ( < 0.05).

摘要

本研究旨在比较术前鼻内给予右美托咪定和口服咪达唑仑对小儿牙科镇静和术后躁动的影响。选择 60 例择期行小儿牙科治疗的患儿(ASA 分级 I 级,年龄 3-6 岁),随机分为右美托咪定(DEX)组和咪达唑仑(MID)组。记录 Ramsay 镇静评分、父母分离焦虑量表、面罩接受度量表、小儿麻醉苏醒期躁动量表和血流动力学参数。观察并记录两组患儿给药前及给药后 10、20、30min 的 Ramsay 镇静评分和血流动力学参数。MID 组和 DEX 组患儿的面罩接受度评分均为 93.33%,两组间差异无统计学意义(>0.05)。“成功与父母分离”的患儿比例分别为 93.33%(MID)和 96.67%(DEX),两组间差异无统计学意义(>0.05)。MID 组患儿躁动发生率为 20%,DEX 组为 0%,差异有统计学意义(<0.05)。鼻内给予右美托咪定和口服咪达唑仑均可提供满意的镇静效果。两组患儿的父母分离焦虑和面罩接受度比较差异无统计学意义(>0.05)。DEX 组患儿术后出现小儿麻醉苏醒期躁动的发生率明显低于 MID 组(<0.05)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4767/7196136/47ce47815ac3/BMRI2020-5142913.001.jpg

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