摘要
目的:探讨雾化吸入右美托咪定作为幼儿行CT/MRI检查前镇静用药的可行性。方法:选取接受CT/MRI检查需镇静的90例患儿,年龄1~3岁,美国麻醉医师协会Ⅰ~Ⅱ级,采用随机数表法分为水合氯醛口服组、右美托咪定滴鼻组和右美托咪定雾化组各30例,在接受CT/MRI检查前分别给予口服水合氯醛60 mg/kg、鼻内滴注右美托咪啶2μg/kg、雾化吸入右美托咪啶2μg/kg进行镇静。记录药物起效时间、检查时间、镇静时间、镇静失败率、不良反应发生率、格罗宁根窘迫评分(GDRS)以及患儿家长满意度和检查医师满意度。结果:右美托咪定滴鼻组和右美托咪定雾化组的镇静时间、镇静失败率、GDRS及苏醒躁动、恶心呕吐发生率均低于水合氯醛口服组,家长和检查医师满意度均高于水合氯醛口服组(P均<0.05)。右美托咪定雾化组的哭闹反应和呛咳反应发生率均低于右美托咪定滴鼻组和水合氯醛口服组(P均<0.05)。结论:雾化吸入和鼻内滴注右美托咪定均可以为幼儿CT/MRI检查提供良好的镇静作用,减轻患儿外周静脉穿刺疼痛,减少不良反应,而雾化吸入右美托咪定的给药途径更安全,易为患儿和家长接受。
Objective:To probe into the feasibility of nebulized inhalation of dexmedetomidine as the sedation for venous puncture and computed tomography(CT)or magnetic resonance imaging(MRI).Methods:Ninety children with sedation(aged from 1 to 3 years,ASAⅠ~Ⅱ)who underwent CT/MRI were randomly divided into the oral chloral hydrate group,the intranasal infusion of dexmedetomidine group and the nebulized inhalation of dexmedetomidine group via the random number table,with 30 cases in each group.Before CT/MRI examination,oral chloral hydrate 60 mg/kg,intranasal infusion of dexmedetomidine 2μg/kg,and atomized inhalation of dexmedetomidine 2μg/kg were administered for sedation.Onset time,examination time,sedation time,rate of sedation failure,incidence of adverse drug reactions,Groningen distress rating scale(GDRS),and the satisfaction of the parents and examination physicians were recorded.Results:The sedation time,failure rate of sedation,GDRS,restlessness,nausea and vomiting in the intranasal infusion of dexmedetomidine group and the nebulized inhalation of dexmedetomidine group were lower than those in the oral chloral hydrate group,and the satisfaction of the parents and examination physicians were higher than that in the oral chloral hydrate group(P<0.05).The incidence of crying reaction and coughing reaction in the nebulized inhalation of dexmedetomidine group was lower than that in the intranasal infusion of dexmedetomidine group and the oral chloral hydrate group(P<0.05).Conclusion:Both nebulized inhalation and intranasal instillation of dexmedetomidine can provide better sedation for CT/MRI,and reduce peripheral venous puncture pain and adverse drug reactions.Nebulized inhalation of dexmedetomidine is safer and more acceptable to the children and parents.
作者
冯毅
刘丹丹
贾玉涛
关静
郭旭伟
马亚飞
Feng Yi;Liu Dandan;Jia Yutao;Guan Jing;Guo Xuwei;Ma Yafei(College of Clinical Medicine,Henan University of Science and Technology,The First Affiliated Hospital of Henan University of Science and Technology,Henan Luoyang 471003,China)
出处
《儿科药学杂志》
CAS
2020年第11期28-31,共4页
Journal of Pediatric Pharmacy
关键词
右美托咪定
雾化吸入
幼儿
影像学检查
静脉穿刺
dexmedetomidine
nebulised inhalation
children
imaging examination
venipuncture
