Clinic Application Of Sufentanil Combined With Dexmedetomidine In Children With Cleft Lip And Palate

Objective To evaluate the safety and efficacyof sufentanil combined with dexmedetomidine (DEX) in children with cleft lip and palate surgery.Methods It is a prospective, double-blind, and placebo controlled study.60 pediatric patients scheduled for elective cleft lip and palatesurgery under general anesthesia were divided into 3 groups randomly (n=20 each):the fentany group (group F),the sufentanil group (group S),the sufentanilanddexmedetomidine group (group Y).After intubation, patients in group Y infused dexmedetomidine from completed intubationuntil 30minbefore the ending of operation. Patients in group F were intravenous fentany (2ug-kg’1),group S and Y were injected sufentanil (0.2ug·kg-1)15min before the end of surgery.Observed and recordedthe followingvital signsdetailedly:Heart rate (HR),Mean arterial pressure (MAP), Nacotrend index (NI) at before entering the operation room (T0),the skin incision (T1),the end of operation (T2),extubation (T3),5min after extubation(T4);pulse oxygen saturation(SpO2),HR,MAP,pain points (FLACC and wong-baker), sedation score (Ramsay) were monitored postoperativel hours(T5),2 hours(T6),4 hours(T7),8 hours(T8) and 24 hours(T9). The total amount ofsevoflurane,observed theoccurrence ofadverse reactions such as postoperative agitation(EA),tested the plasma concentrations of beta-endorphin at T0,T5,T9.Results Compared with group F,the hemodynamics was more steady and smooth in groupY (P<0.05).At T1,the NI in group Y was significantly less than the other two groups’s (P<0.05).The time to extubation after surgery was longer in group Y(P<0.05).Compared with group F,the scores of Ramsay,FLACC and Wong-baker at T5～T6 were visibly higher than that in group Y(P<0.05).The incidence and the grading of EA in group Y were lower than that in group S and group F(P<0.05).Compared with group Y,the plasma concentrations of beta-endorphin in group S and group F were lower at T9(P<0.05).Conclusion Sufentanil combined with DEX can provide adequate anesthesia depth, stabilityhemodynamic,avourable postoperative analgesia,high safety coefficient and a low incidence of adverse reactions.