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右美托咪定作为儿科麻醉前用药对行为的影响:一项前瞻性观察研究。

Effect on the behaviour of dexmedetomidine as anaesthetic premedication in the paediatric population: a prospective observational study.

作者信息

Monteiro M, Cristiani F

机构信息

Asistente de Departamento y Cátedra de Anestesiología. Universidad de la República. Médico Anestesista del Centro Hospitalario Pereira Rossell- Hospital Pediátrico. Montevideo, Uruguay.

Profesor Adjunto de Departamento y Cátedra de Anestesiología. Universidad de la República. Médico Anestesista del Centro Hospitalario Pereira Rossell-Hospital Pediátrico. Montevideo, Uruguay.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2021 Apr;68(4):179-182. doi: 10.1016/j.redar.2020.05.020. Epub 2020 Sep 1.

Abstract

Premedication in the pediatric population is of vital importance to reduce anxiety and facilitate anesthetic induction. Midazolam and ketamine have been used for this purpose, drugs that have shown long-term changes in neurodevelopment. Dexmedetomidine promotes a sedative, analgesic effect and lacks neurotoxic effects, its intranasal application is easy and minimally invasive. We studied the sedative and behavioral effect of intranasal dexmedetomidine 2 mcg/kg in ASA 1 and 2 children for elective surgery. They were evaluated at 10, 20 and 30 minutes of administered, in the separation of the parents and placement of the mask for inhalation induction with behavioral and sedation scores (classified from 1 to 4), we considered acceptable for admission to operating room categories 3 and 4. RESULTS: Thirty patients between 1 and 10 years old were included in the period from September 2017 to April 2018. The sedation score obtained at 30minutes was acceptable in 46.6% of the patients and the behavior score was in 96% of the cases. In 63% of cases the acceptance of the facial mask placement for inhalation induction was achieved. The procedure was well tolerated in all cases and parents were satisfied in 100% of the cases.

摘要

在儿科患者中进行术前用药对于减轻焦虑和促进麻醉诱导至关重要。咪达唑仑和氯胺酮已用于此目的,但这些药物已显示出对神经发育的长期影响。右美托咪定具有镇静、镇痛作用且无神经毒性作用,其鼻内给药简便且微创。我们研究了2 mcg/kg鼻内给予右美托咪定对择期手术的ASA 1和2级儿童的镇静和行为影响。在给药后10、20和30分钟进行评估,在父母分离和放置面罩进行吸入诱导时,采用行为和镇静评分(从1到4分级),我们认为3级和4级可接受进入手术室。结果:在2017年9月至2018年4月期间纳入了30例1至10岁的患者。30分钟时获得的镇静评分在46.6%的患者中可接受,行为评分在96%的病例中可接受。在63%的病例中成功接受了用于吸入诱导的面罩放置。所有病例对该操作耐受性良好,100%的病例中家长感到满意。

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