Study of intranasal dexmedetomidine on surgery for Patient of epidermolysis bullosa
王俊鹏1
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作者信息
1. 郑州大学第二附属医院麻醉科 郑州 450014
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摘要
目的 评价右美托咪定滴鼻麻醉用于大疱表皮松解症(EB)矫形手术的效果.方法 择期行双手假性并指矫形手术EB患儿41 例,按照随机数字表法分为右美托咪定组(D组,21 例)和对照组(N 组,20 例).D组于入手术室前 30 min 经鼻滴注2 ug/kg右美托咪定,N组给予等量生理盐水经鼻滴注.记录患儿入室前与家长分离时的Ramsay评分,记录患儿术中追加氯胺酮次数、手术时间、苏醒时间及术后24 h FLACC疼痛评分.统计患儿术中呼吸抑制、苏醒期躁动发生例数和新发大疱数.结果 D组患儿的Ramsay评分高于N组,氯胺酮追加次数和术后苏醒期躁动例数均少于N组,差异有统计学意义(P＜0.05).2 组患儿呼吸抑制发生次数、术后苏醒时间、FLACC评分、新发大疱数的差异均无统计学意义(P＞0.05).结论 右美托咪定滴鼻麻醉用于大疱表皮松解症患儿矫形手术,可有效减轻患儿与家长分离障碍,与麻醉药物起协同作用,减少术中氯胺酮追加次数、苏醒期躁动次数,而且对患儿苏醒时间及术后疼痛程度均无影响.
Abstract
Objective To evaluate the effect of intranasal dexmedetomidine on surgery for Patient with epidermolysis bullosa.Methods Selected the 43 cases orthopedic surgery patients with EB,which is divided into two group:Dexmedetomidine group(group D,21 cases)and control group(group N,20 cases).Group D was injected with dexmedetomidine 2ug/kg by nasal drip 30min before entering the operation room,and the group N was given the same amount of normal saline by nasal drip.Recording Ramsay scores of chil-dren before the burglary when patients separated from their families,Recording Each number of children with ketamine additional surgery,surgery time,recovery time and postoperative pain scores 24 h FLACC.Recording the number of children surgery cases of respiratory de-pression,the number of cases of restlessness,the number of new bullous.Results Group D Patients Ramsay score was significantly higher than that in group N.The Ramsay score of children in Group D was higher than that of group N,The number of ketamine additions and the number of postoperative agitation were less than that of group N(P＜0.05).The number of respiratory depression,postoperative recovery time,FLACC score,and new bullous number were not statistically significant(P＞0.05).Conclusion The application of dexmedetomidine in the surgery of patients with bullous epidermolysis can effectively alleviate the separation of patients from family mem-bers.Synergistically with anesthetic drugs,reduce the number of intraoperative ketamine additions,Alleviate the awakening period,no effect on the patient's recovery time and postoperative pain.
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