Effects of Intranasal Mucosal Administration of Dexmedetomidine on Perioperative Blood Gas Indicators and Extubation Quality of Laparoscopic Hernia Repair in Children

Lu Qing; Chen Juan; Wang Lihua; Zhou Menghu

doi:10.13407/j.cnki.jpp.1672-108X.2022.05.012

您当前的位置：

首页 >

文章列表页 >

Effects of Intranasal Mucosal Administration of Dexmedetomidine on Perioperative Blood Gas Indicators and Extubation Quality of Laparoscopic Hernia Repair in Children

更新时间：2022-06-10

- Effects of Intranasal Mucosal Administration of Dexmedetomidine on Perioperative Blood Gas Indicators and Extubation Quality of Laparoscopic Hernia Repair in Children
- Vol. 28, Issue 5, Pages: 44-48(2022)
- 作者机构：
  
  安徽省池州市人民医院,安徽,池州,247000
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2022.05.012
  CLC：
- Published：2022，
扫描看全文
Lu Qing, Chen Juan, Wang Lihua, et al. Effects of Intranasal Mucosal Administration of Dexmedetomidine on Perioperative Blood Gas Indicators and Extubation Quality of Laparoscopic Hernia Repair in Children. [J]. 28(5):44-48(2022)
DOI：

Lu Qing, Chen Juan, Wang Lihua, et al. Effects of Intranasal Mucosal Administration of Dexmedetomidine on Perioperative Blood Gas Indicators and Extubation Quality of Laparoscopic Hernia Repair in Children. [J]. 28(5):44-48(2022) DOI： 10.13407/j.cnki.jpp.1672-108X.2022.05.012.

摘要

目的：探讨右美托咪定（Dex）经鼻腔黏膜给药对小儿腹腔镜疝修补术围术期血气指标及拔管质量的影响。方法：选取2020年1月至2021年4月我院拟行腹腔镜疝修补术的患儿80例，根据随机数字表法分为对照组（n=26）、Dex 1组（n=27）和Dex 2组（n=27）。比较三组患儿术前、气腹后5 min以及放气后30 min动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）和pH；比较三组患儿使用Dex前（T0）、Dex用药30 min后（T1）、手术开始3 min（T2）和手术结束3 min（T3）时血氧饱和度（SpO2）、心率（HR）、平均动脉压（MAP）；比较三组患儿苏醒时间、拔管时间、拔管质量、躁动评分和不良反应发生率。结果：对照组气腹后5 min PaO2、pH、PaCO2分别为（73.16±7.45）mm Hg、7.21±0.06、（45.16±5.96）mm Hg；Dex 1组和Dex 2组气腹后5 min PaO2分别为（78.46±6.64）mm Hg、（79.43±6.51）mm Hg，pH分别为7.38±0.10、7.49±0.08，均较对照组升高，PaCO2分别为（40.14±4.19）mm Hg、（37.06±4.32）mm Hg，均较对照组降低（P<0.05）；Dex 2组气腹后5 min pH高于Dex 1组，PaCO2低于Dex 1组（P<0.05）。Dex 1组和Dex 2组T1、T2、T3时HR、MAP降低（P<0.05）；Dex 2组T1、T3时HR低于Dex 1组，T1时MAP低于Dex 1组（P<0.05）；Dex 1组和Dex 2组T1、T2、T3时HR、MAP均较T0时降低（P<0.05）。对照组拔管评分和躁动评分分别为（4.51±0.95）分、（13.25±2.59）分，Dex 1组拔管评分和躁动评分分别为（2.93±1.03）分、（9.27±2.23）分，Dex 2组拔管评分和躁动评分分别为（2.15±1.14）分、（6.38±2.62）分，与对照组比较，Dex 1组和Dex 2组拔管评分和躁动评分降低，且Dex 2组低于Dex 1组（P<0.05）。3组患儿苏醒时间、拔管时间、不良反应发生率比较，差异无统计学意义（P>0.05）。结论：经鼻腔黏膜给予Dex，可有效改善行腹腔镜疝修补术患儿围术期呼吸循环功能，减轻拔管应激反应和苏醒期躁动反应，且不延长拔管时间，不增加不良反应发生率，安全可靠。

Abstract

Objective: To probe into the effects of intranasal mucosal administration of dexmedetomidine (Dex) on perioperative blood gas indicators and extubation quality of laparoscopic hernia repair in children. Methods: From Jan. 2020 to Apr. 2021

80 children undergoing laparoscopic hernia repair in our hospital were extracted to be divided into the control group (n=26)

Dex 1 group (n=27) and Dex 2 group (n=27) via the random number table method. The arterial blood partial pressure of oxygen (PaO2)

partial pressure of carbon dioxide (PaCO2) and pH were measured before surgery

5 minutes after pneumoperitoneum

and 30 minutes after deflation among three groups of children. Blood oxygen saturation (SpO2)

heart rate (HR) and mean arterial pressure (MAP) before administration of Dex (T0)

30 min after administration of Dex (T1)

3 min at the beginning of surgery (T2) and 3 min at the end of surgery (T3) were compared among three groups. The awaking time

extubation time

extubation quality

restlessness score and incidence of adverse drug reactions were compared among three groups. Results: The levels of PaO2

pH and PaCO2 at 5 min after pneumoperitoneum in the control group were respectively (73.16±7.45) mm Hg

7.21±0.06 and (45.16±5.96) mm Hg. The levels of PaO2 at 5 min after pneumoperitoneum in the Dex 1 and Dex 2 groups were respectively (78.46±6.64) mm Hg and (79.43±6.51) mm Hg

and pH values were respectively 7.38±0.10 and 7.49±0.08

all higher than those in the control group. The levels of PaCO2 in the Dex 1 and Dex 2 groups were respectively (40.14±4.19) mm Hg and (37.06±4.32) mm Hg

all lower than those in the control group (P<0.05). The pH at 5 min after pneumoperitoneum in Dex 2 group was higher than that in Dex 1 group

and PaCO2 was lower than that in Dex 1 group (P<0.05). HR and MAP at T1

T2 and T3 decreased in Dex 1 and Dex 2 groups (P<0.05). HR at T1 and T3 in Dex 2 group was lower than that in Dex 1 group

MAP at T1 was lower than that in Dex 1 group (P<0.05). HR and MAP at T1

T2 and T3 in Dex 1 and Dex 2 groups were lower than those at T0 (P<0.05). The extubation scores and restlessness scores were (4.51±0.95) points and (13.25±2.59) points for the control group

(2.93±1.03) points and (9.27±2.23) points for the Dex 1 group

and (2.15±1.14) points and (6.38±2.62) points for the Dex 2 group

respectively. Compared with the control group

the extubation scores and restlessness scores of the Dex 1 group and Dex 2 group were lower

and the Dex 2 group was lower than the Dex 1 group (P<0.05). There were no statistically significant differences in the awakening time

extubation time and incidence of adverse drug reactions among three groups (P>0.05). Conclusion: The administration of Dex through the nasal mucosa can effectively improve the respiratory and circulatory function of children undergoing laparoscopic hernia repair

reduce the stress response to extubation and agitation during the recovery period

and does not prolong the extubation time or increase the incidence of adverse drug reactions with higher safety.

关键词

腹腔镜疝修补术右美托咪定血气指标拔管质量小儿

Keywords

laparoscopic hernia repairexmedetomidineblood gas indicatorextubation qualitychildren

references

查看原文

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Effects of Dexmedetomidine Nasal Drops Combined with Sevoflurane Inhalation Induction on Cerebral Oxygen Metabolism and Cognitive Function in Children Undergoing Interventional Occlusion of Congenital Heart Disease

Effects of Dexmedetomidine on Inflammatory Response and Oxidative Stress in Children During One Lung Ventilation

Comparison on Effects of Different Doses of Dexmedetomidine on Emergency Agitation and Hemodynamicsin Children with OSAHS after Palatopharyngoplasty

The Safety of Esketamine Combined with Dexmedetomidine for Pediatric Painless Fiberoptic Bronchoscopy

Effects of Remifentanil Combined with Low-Dose Sufentanil on Hemodynamics and Postoperative Anesthesia Recovery in Interventional Surgery for Congenital Heart Disease in Children

Related Author

Pang Xiaoyi

Liu Hong

Du Qian

Wen Xu

Wang Rong

Zhang Wenjing

Qu Shuangquan

Yan Lulu

Related Institution

Mianyang 404 Hospital

Hunan Children’s Hospital, Changsha

Shanghai Baoshan Hospital of Integrated Traditional Chinese Medicine andWestern Medicine, Shanghai

Shanghai Children’ s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai

Zhangjiakou First Hospital

⁰