Clinical observation of dexmedetomidine in preventing abnormal respiration after tracheal extubation under general anesthesia in children undergoing tonsillectomy and adenoidectomy
Objective To observe the clinical effect of dexmedetomidine(DEX)in preventing abnormal respiration after tracheal extubation under general anesthesia in children undergoing tonsillectomy and adenoidectomy.Methods 120 children underwent tonsillectomy and adenoidectomy were divided into a study group and a control group by random number table method,with 60 cases in each group.The study group was infused with DEX at a calculated amount of 0.5 μg/kg,and the control group was infused with the same calculated amount of 0.9%sodium chloride.Record and comparison were made on operation time,postoperative extubation time,post-anesthesia care unit(PACU)length of stay,heart rate(HR)and mean arterial pressure(MAP)at different time points[before anesthesia(T1),immediately after intubation(T2),beginning of surgery(T3),immediately after extubation(T4),and leaving PACU(T5)],abnormal respiration,progressive in blood oxygen saturation(SpO2)decline,negative pressure pulmonary edema between the two groups.Results There was no statistically significant difference in operation time,extubation time and PACU length of stay between the two groups(P>0.05).In the study group,the HR at T2,T3,T4 and T5 were(96.6±4.3),(95.4±7.6),(90.6±3.5)and(92.3±5.4)beats/min,which were lower than(104.3±3.6)beats/min at T1;and the MAP were(75.4±4.8),(73.3±4.4),(71.5±3.4)and(72.2±3.6)mm Hg(1 mm Hg= 0.133 kPa),which were lower than(81.5±3.3)mm Hg at T1.In the control group,the HR at T2,T3,T4 and T5 were(110.2±5.6),(123.6±6.4),(115.7±4.5)and(108.3±6.8)beats/min,which were higher than(105.3±5.1)beats/min at T1;and the MAP were(85.3±6.7),(89.3±4.3),(84.2±3.8)and(85.6±2.7)mm Hg,which were higher than(80.2±5.5)mm Hg at T1.The levels of HR and MAP at T2,T3,T4 and T5 in the study group were lower than those in the control group(P<0.05).The incidence of abnormal respiration,progressive SpO2 decline and negative pressure pulmonary edema in the study group were 6.7%,0 and 0,which were lower than 23.3%,6.7%and 6.7%in the study group,with statistical significance(P<0.05).Conclusion The incidence of abnormal respiration after tracheal extubation in children undergoing tonsillectomy and adenoidectomy is high.Low-dose DEX infusion can help to maintain the stability of hemodynamics in children,and can significantly reduce the incidence of abnormal respiration,and has no significant effect on the recovery time of children,which is worth popularizing.
DexmedetomidineTonsillectomy and adenoidectomyAbnormal respiration
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