右美托咪定滴鼻联合腹横肌平面阻滞对小儿腹腔镜疝手术术后苏醒期的影响观察

来源:用户上传      作者:张彬彬 李国建 王珂

　　[摘要]目的探右美托咪定滴鼻联合腹横肌平面阻滞（TAPB）对小儿腹腔镜疝手术术后苏醒期的影响。方法选取2021年1―6月在佛山市顺德区容桂街道新容奇医院行腹腔镜疝手术治疗的120例患儿为研究对象，采用随机排列法分为对照组（ n=60）和观察组（ n=60）。麻醉诱导后，观察组患儿于双侧鼻孔处滴入1μg/kg 的右美托咪定，对照组患儿于双侧鼻孔处各滴入等剂量的生理盐水，两组均在超声引导下进行 TAPB。分别于麻醉前（T0）、术后1 h（T1）、术后6 h（T2）、术后12 h（T3）和术后24 h（T4）观察患儿镇静、心率和平均动脉压水平，比较两组麻醉安全性。结果两组 T0阶段镇静评分、心率和平均动脉压水平比较，差异无统计学意义（ P >0.05）;观察组 T1～ T4阶段镇静评分均高于对照组，心率和平均动脉压水平均低于对照组，差异有统计学意义（ P <0.05）。两组在 T0～ T4阶段镇静评分、心率和平均动脉压水平组内比较差异均存在统计学意义（P <0.05）。观察组不良反应总发生率为6.67%，低于对照组的21.67%，差异有统计学意义（ P <0.05）。结论对行腹腔镜疝手术患儿实施右美托咪定滴鼻联合 TAPB 具有较好的镇静效果，在保障患儿安全的同时维持其生命体征的稳定，临床应用效果显著。
　　[关键词]右美托咪定;腹横肌平面阻滞;小儿腹腔镜疝手术;镇静;血流动力学
　　[中图分类号] R726.1 [文献标识码] A [文章编号]2095-0616（2022）09-0149-04
　　Observation on impacts of dexmedetomidine nasal drops combined with transversus abdominis plane block on the recovery period after laparoscopic hernia surgery in children
　　ZHANG Binbin LI Guojian WANG Ke
　　Department of Anesthesiology， Shunde New Rongqi Hospital of Ronggui Street of Shunde District in Foshan City， Guangdong， Foshan 528303， China
　　[Abstract] Objective To investigate the impacts of dexmedetomidine nasal drops combined with transversus abdominis plane block （TAPB） on the recovery period after laparoscopic hernia surgery in children. Methods A total of 120 children who underwent laparoscopic hernia surgery in Shunde New Rongqi Hospital of Ronggui Street of Shunde District in Foshan City from January to June 2021 were selected as the research object， and they were divided into the control group （n=60） and the observation group （n=60） according to the random arrangement method. After anesthesia induction， 1μg/kg dexmedetomidine was dripped into both nostrils of children in the observation group， while the same volume of normal saline was dripped into both nostrils of children in the control group. TAPB was performed under the guidance of ultrasound in both groups. The levels of sedation， heart rate and mean arterial pressure were observed before anesthesia （T0）， 1 hour after surgery （T1）， 6 hours after surgery （T2）， 12 hours after surgery （T3） and 24 hours after surgery （T4） respectively， and the anesthetic safety of the two groups was compared. Results There were no statistically significant contrast differences in sedation score， heart rate and mean arterial pressure levels between the two groups at T0 stage （P >0.05）. The sedation scores of the observation group during T1～ T4 stages were all higher than those of the control group， and the heart rate and mean arterial pressure levels were all lower than those of the control group， with statistically significant differences （P <0.05）. There were statistically significant differences in sedation scores， heart rate and mean arterial pressure levels between the two groups at T0～ T4 stages （P <0.05）. The total incidence of adverse reactions in the observation group was 6.67%， lower than 21.67% in the control group， with statistically significant difference （P <0.05）. Conclusion The application of dexmedetomidine nasal drops combined with TAPB in children undergoing laparoscopic hernia surgery has a relatively goodsedative effect， which can ensure the safety of children and maintain the stability of vital signs， with significant effects in clinical application.

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