Effect Of Perioperative Agitation With Dexmedetomidine On Children Undergoig Tonsillectomy And Adenoidectomy

Objective To analyze the effect of dexmedetomidine under general anesthesia on agitationin children undergoing tonsillectomy and adenoidectomy.Methods Choose 60 patients who underwent tonsillectomy and adenoidectomy in Yanbian university affiliated hospital from January 2018 to December 2019.Randomly divided to three groups(n=20):in group D1,the loading dose of dexmedetomidine was 0.4 μg/kg for 10 minutes,then continuously pumped in 0.4μg/kg·h,in group D2,the loading dose of dexmedetomidine was 0.8 μg/kg for 10 minutes,then continuously pumped in 0.8μg/kg·h,group S was the control group and pumped with the same amount of 0.9%normal saline.Analyze the differences of basic information,operation time,anesthesia time,extubation time,recovery time and Aldrete>9 time among the three groups,Analyze the changes of vital signs in 5 minutes before anesthesia(T1),5 minutes before extubation(T2),5 minutes after extubation’(T3),15 minutes(T4),30 minutes(T5).The sedation,restlessness,Ramsay score,paed score and restlessness rate of the three groups were compared.Statistics of adverse reactions and satisfaction of family members.Result(1)There was no statistical significance in gender,height,weight,operation time and anesthesia time of patients in three groups(P>0.05).(2)Comparison of MAP among the three groups,at the time points of T2-T5,the MAP of group D1 and group D2 was lower than group S.The difference was statistically significant(P<0.05).The HR of the three groups were compared,the HR of group D1 and group D2 was lower than group S at the time of T3-T5,the difference was statistically significant(P<0.05).(3)Comparison of Aldrete>9 time among the three Groups,group S>g roup D1>group D2,Awakening and extubation time had no statistical significa nce(P>0.05).(4)Comparison of PAED scores among the three groups,group S>group D1>group D2 at the time point of T6-T8,the difference was statistically significant,(P<0.05).Ramsay scores in three groups,group D1 and group D2 were lower than group S,the difference was statistically significant(P<0.05).(5)There were no significant differences of adverse reactions among the three groups(P>0.05),the difference was not statistically significant(P>0.05).No larynx and airway spasm occurred in the three groups.(6)Comparing the family satisfaction of patients in the three groups,group D1 and D2 were higher than group S,the difference was statistically significant(P<0.05).The incidence of restlessness in group S(40%)>group D1(10%)>group D2(5%),the difference was statistically significant(P<0.05).Conclusion(1)After induction of general anesthesia,intravenous injection of dexmedet omidine(0.4μg/kg·h or 0.8μg/kg·h)can effective reduce the incidence of periop erative agitation in children undergoing tonsillectomy and adenoidectomy,with st able hemodynamics.The effective is better to pump dexmedetomidine 0.8μg/kg·h.(2)No respiratory inhibition,no longer extubation time,no obvious adverse reactions,can be safely and effectively used in children.