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。
Study of intranasal dexmedetomidine on surgery for Patient of epidermolysis bullosa
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.
万方数据
维普
