Clinical Study Of Preoperative Sedation With Intronasal Different Doses Of Dexmedetomidine In Padiatric With Tongue Ligament Correction

OBJECTIVE:To investigate the effect of nasal administration of dexmedetomidine hydrochloride for 30 minutes before surgery on anesthesia in children with tongue ligament correction under sevoflurane inhalation anesthesia.METHODS:A total of 120 children（ASA I?II）aged 1?6 years treated with tongue ligament correction under general anesthesia with sevoflurane inhalation were involved into the study.120 patients were divided into control group,dexmedetomidine 1μg/kg group and dexmedetomidine 2μg/kg by random number table method,40 cases in each group.The children underwent routine banned and fasted before surgery.30 min before surgery,the dexmedetomidine was administered nasally according to the group dose.After30 minutes,the children were brought into the operating room and received a sevoflurane inhalation anesthesia to accept the lingual ligament correction surgery with autonomous respiration.Observed the sedation of the child when enter into the operating room,the mask received during the induction of sevoflurane anesthesia,the agitation after the recovery,and the occurrence of postoperative hypoxemia,hemorrhage,nausea and vomiting.Record heart rate（HR）,blood oxygen saturation（SpO₂）,and mean blood pressure（MAP）of the child before administration,when enter into the operating room,3 minutes after surgery,and 3 minutes after surgery.RESULTS:There were no significant differences in gender,age,weight,and operation time between the three groups（P>0.05）.When entering the operating room,the sedation satisfaction of the children in the dexmedetomidine1μg/kg group and the dexmedetomidine 2μg/kg group was significantly higher than that in the blank group（P<0.05）.The sedation score of the children in the dexmedetomidine 2μg/kg group was significantly higher than that in the dexmedetomidine 1μg/kg group.There was no significant difference in the satisfaction of sedation（P>0.05）.When inhaled sevoflurane for anesthesia induction,the mask satisfaction of children in dexmedetomidine 1μg/kg group and group dexmedetomidine 2μg/kg was significantly higher than that in the blank group（P<0.05）;and the satisfaction of masks in group dexmedetomidine2μg/kg was better than that in dexmedetomidine 1μg/kg group.The difference was statistically significant（P<0.05）.There were no significant differences in preoperative HR between the three groups（P>0.05）.The HR of the children in the medication group was lower than that before the treatment（P<0.05）.The HR of the children was lower than that of the blank group,and the difference was statistically significant（P<0.05）.Among them,the HR of the dexmedetomidine 2μg/kg group was the most obvious,and the two children developed bradycardia when compared with the dexmedetomidine 1μg/kg group.Statistically significant（P>0.05）.The MAP of children in the medication group was reduced by about 10%from the baseline value,and the difference was statistically significant（P<0.05）.From the beginning of the operation to the recovery of the child,the MAP of the untreated group was also reduced by about 10%from the baseline value,and the difference was statistically significant（P<0.05）.After operation,the recovery time of children in dexmedetomidine 1μg/kg group and dexmedetomidine 2μg/kg groups was significantly longer than that in the blank group（P<0.05）.The dexmedetomidine 2μg/kg group with the larger dose had the longest recovery time,compared with dexmedetomidine 1μg/kg group.Statistical significance（P<0.05）.When awakening,the agitation scores of the children in the dexmedetomidine 1μg/kg group and the dexmedetomidine 2μg/kg group were significantly lower than those in the blank group（P<0.05）.The agitation scores in the dexmedetomidine 2μg/kg group were lower than those in the dexmedetomidine 1μg/kg group.The difference was statistically significant（P<0.05）.There was no significant difference in the incidence of postoperative hypoxemia,wound hemorrhage,and vomiting between the three groups（P>0.05）.CONCLUSION:dexmedetomidine hydrochloride 1μg/kg or 2μg/kg can be delivered by nasal nebulization 30 min before surgery for children aged 1 to 6years with sevoflurane inhalation anesthesia for tongue ligament correction.Good preoperative sedation,and help to improve the satisfaction of the mask when the inhalation anesthesia is induced and reduce the rate of postoperative recovery.A dose of dexmedetomidine hydrochloride 2μg/kg can provide a more satisfactory sedative effect and a more satisfactory mask acceptance,but dexmedetomidine hydrochloride 2μg/kg may cause bradycardia and prolong postoperative The adverse effects of wake-up time require clinicians to strengthen the monitoring of vital signs after medication.