【摘要】 目的比较等剂量右美托咪定滴鼻或含服用于患儿面罩吸入麻醉诱导前镇静效果。方法选择ASAⅠ级接受面罩吸入麻醉诱导患儿76例,年龄2⁶岁,随机分为两组,每组38例。麻醉1 h前,滴鼻组和含服组分别经鼻滴入或口内含服右美托咪定2.5μg·kg^-1。给药1 h后患儿与家属分离,送入手术室进行面罩吸入5%七氟烷麻醉诱导。记录给药前（T₀）及给药后20、40、60 min（T₂、T₃、T₄）时患儿的心率（HR）、收缩压（SBP）、脉搏血氧饱和度（SpO₂）及Ramsay镇静评分,评估给药时患儿药物接受程度、与父母分离时镇静状态及面罩接受程度。结果与T₀时比较,两组T₂、T₃、T₄时Ramsay镇静评分均上升（P<0.05）,T₃、T₄时滴鼻组高于含服组（P<0.05）。滴鼻组患儿药物接受满意率低于含服组（P<0.05）,面罩接受满意率高于含服组（P<0.05）,与父母分离时镇静满意率组间比较无显著差异（P>0.05）。与T₀时比较,两组T₃、T₄时HR、SBP均降低（P<0.05）,组间比较无显著差异（P>0.05）。结论患儿麻醉前滴鼻给予右美托咪定2.5μg·kg^-1面罩吸入麻醉诱导前镇静效果优于等剂量含服给药,但含服给药患儿更容易接受。更多还原

【Abstract】 AIM To compare the sedation effect of the same dose of intranasal and buccal dexmedetomidine for mask acceptance during inhalational induction in pediatric patients. METHODS Seventy-six patients, ASA physical status Ⅰ, aged 2 to 6 years, scheduled for acceptance of face mask during inhalational induction were randomly divided into two groups, with 36 in each. The buccal group or the intranasal group received dexmedetomidine, either 2.5 μg·kg^-1 intranasally or 2.5 μg·kg^-1 buccally for premedication at one hour before the induction of anesthesia. They were separated from parents and transferred to the operating room at one hour after received dexmedetomidine. Anesthesia induction was performed with 5%sevoflurane using face mask. Heart rate（HR）, systolic blood pressure（SBP）, pulse oxygen saturation（SpO₂）and Ramsay sedation scores were measured before（T₀） and every 20 min（T₂, T₃ and T₄） after administering dexmedetomidine in all patients. Drug acceptance, parental separation, and face mask acceptance scores were recorded. RESULTS Compared with T₀, Ramsay sedation scores were increased in both groups at T₂, T₃ and T₄（P < 0.05）, and significantly higher in the intranasal group than the buccal group at T₃ and T₄（P < 0.05）.Drug acceptance satisfaction rate was significantly lower in the intranasal group than in the buccal group（P <0.05）. Face mask acceptance satisfaction rate was significantly higher in the intranasal group than in the buccal group（P < 0.05）. There was no significant difference between the two groups in parental separation（P > 0.05）.HR and SBP were significantly lower in both groups at T₃ and T₄ compared with T₀（P < 0.05）, and there was no significant difference between the two groups（ P > 0.05）. CONCLUSION Intranasal dexmedetomidine2.5 μg·kg^-1 is more effective than buccal dexmedetomidine 2.5 μg·kg^-1 for mask acceptance during inhalational induction in pediatric patients, but buccal dexmedetomidine is more acceptable for children.更多还原