The effects of esketamine combined with dexmedetomidine preoperative nasal drops on hemodynamic level and myocardial oxidative stress injury in children undergoing surgery for congenital heart disease
Objective To explore the effects of esketamine combined with dexmedetomidine preoperative nasal drops on hemodynamic level and myocardial oxidative stress injury in children undergoing surgery for congenital heart disease.Method 110 children undergoing surgery for congenital heart disease admitted to Hainan Women and Children Medical Center from January 2020 to January 2023 were studied.They were divided into control group and observation group by random number table method,with 55 cases in each group.The control group was given dexmedetomidine monotherapy preoperative nasal drops,and the observation group was given esketamine combined with dexmedetomidine preoperative nasal drops.The operation related indexes in the two groups were compared and analyzed.The hemodynamic levels(HR,MAP)between the two groups were compared before anesthesia,after skin incision,after sternal splitting and after surgery.Myocardial oxidative stress injury indexes(CK-MB,cTnI)before and 6,24 and 48 h after surgery,postoperative adverse reactions were compared between the two groups.Result The sedation time and the dosage of dexmedetomidine nasal drops in the observation group were shorter or less than those in the control group,and the differences were statistically significant(P＜0.05).Compared with before anesthesia,the HR in two groups decreased after skin incision,after sternal splitting and after surgery,and the MAP in the observation group decreased after skin incision,after sternal splitting,and the differences were statistically significant(P＜0.05).The HR in observation group was lower than that in control group after skin incision,after sternal splitting,and the MAP in the observation group was lower than that in the control group after sternal splitting,and the differences were statistically significant(P＜0.05).Compared with preoperative,CK-MB and cTnI in two groups were increased at 6,24 and 48 h after surgery,with statistical significance(P＜0.05).There was no significant difference in CK-MB and cTnI between the two groups before and 6,24 and 48 h after surgery(P＞0.05).There was no significant difference in the total incidence of postoperative adverse reactions between the two groups(P＞0.05).Conclusion Compared with dexmedetomidine monotherapy nasal drops,esketamine combined with dexmedetomidine preoperative nasal drops can significantly shorten the sedation time of children,and reduce the dosage of dexmedetomidine,and maintain the stability of hemodynamic level,and do not aggravate myocardial oxidative stress injury in children undergoing surgery for congenital heart disease.
万方数据
维普
