Effects Of Dexmedetomidine Nasal Drip The Application Of Epinephrine In Pediatric Tonsil Surgery

Objectives:The purpose of this study was to investigate the effect of dexmetomidine nasal drops on hemodynamics of tonsillectomy in children and the quality of the recovery period.Methods:120 cases of ASA1-2,aged from 4 to 7 and weighed from16 to 28 kilograms were conducted selective tonsillectomy under general anesthesia.The 120 patients were randomly divided into 3 groups?Group D₁,Group D₂ and Group C,n=40?,and respectively nasal dripped with1.0?g/kg?Group D₁?or 2.0?g/kg?Group D₂?of dexmedetomidine and the same volume of normal saline?Group C?30 minutes before the operation.Then the patients' mean arterial pressure?MAP?and heart rate were monitored at the following time points,pre-nose-spray?T₀?,induction?T₁?,trachea intubation?T₂?,before the injection of epinephrine?T₃?,injection of epinephrine?T₄?,5 mins after epinephrine injection?T₅?,at the end of the operation?T₆?,extubation?T₇?and 5 mins after extubation?T₈?and the recovery time after drug withdrawal?respiratory recovery time,eye opening time,directional recovery time,extubation time?,and the amount of sevoflurane.Furthermore,the incidence were recorded such as restlessness,cough,nausea,vomiting.Results:The blood pressure and heart rate of the patients in Group C increased at the time of T₂?T₃?T₄?T₅?T₆?T₇ and T₈,compared with T₀,the differences in Group C were statistically significant?P<0.05?.And at the time of T₄ and T₅,compared with T₃,the differences in Group C were also statistically significant?P<0.05?.In addition,at the time of T₁?T₂?T₃?T₄?T₅?T₆?T₇ and T₈,the blood pressure and heart rate of the patients in Group C is obviously higher than those in Group D,thus the differences between Group C and Group D were statistically significant?P<0.05?.However,the differences between Group D₁ and Group D₂ were not statistically significant?P>0.05?.As for the time of respiratory recovery,eyes opening response,orientation recovery and tracheal extubation of the patients in Group D was obviously shorter than that in Group C,the differences among these groups were statistically significant?P<0.05?while the differences between Group D₁ and D₂ were not statistically significant?P>0.05?.The use of sevoflurane of the patients in Group D was under that in Group C,the differences among these groups were statistically significant?P<0.05?while the differences between Group D₁ and D₂ were not statistically significant?P>0.05?.The incidence of restlessness,cough,decreased SPO₂?SPO₂<92%?,nausea and vomiting in group C were significantly higher than those in group D₁and group D₂?P<0.05?.There were no significant differences between group D₁ and group D₂?P<0.05?.Conclusion:1.Nasal drip 1.0?g/kg and 2.0?g/kg of dexmedetomidine 30 minutes before the operation to patients in infantile tonsil surgery with epinephrine can maintain hemodynamic stability during the period operation shorten the recovery time of the children,reduce the use of sevoflurane and the occurrence of restlessness,cough and other complications during the recovery.And it can also effectively improve the quality of anesthesia and recovery.2.Nasal dripping 2.0?g/kg of dexmedetomidine 30 minutes before the operation to the patients may be a better choice.