Objective: To probe into the application value of dexmedetomidine nasal drops combined with sevoflurane inhalation induction in children undergoing interventional occlusion of congenital heart disease. Methods: From Apr. 2020 to Apr. 2021

87 children with congenital heart disease who received interventional occlusion in our hospital were selected. According to the admission sequence

the odd number was included in the observation group (n=44)

and the even number was included in the control group (n=43). The observation group was treated with dexmedetomidine hydrochloride by nasal drip 30 min before surgery

while the control group received the same amount of normal saline. After that

all patients were induced anesthesia with 8% sevoflurane mask inhalation

and 5% sevoflurane maintained anesthesia. The heart rate (HR) and mean arterial pressure (MAP) of two groups were recorded before nasal drip (T0)

after nasal drip of 10 min (T1)

after nasal drip of 30 min (T2)

before anesthesia induction (T3)

after anesthesia induction (T4)

at the end of surgery (T5) and at the time of awakening (T6). The blood of radial artery and internal jugular vein bulb were collected

and the difference of internal jugular artery and vein oxygen content (Da-jvO2 )

cerebral oxygen extraction (CERO2 )

difference of blood glucose (A-VGlu)

difference of lactate (A-VLac) were calculated. The cognitive function of children was evaluated by Wechsler intelligence scale for children-Ⅳ (WISC-Ⅳ) before surgery of 24 h

after surgery of 1 week

3 months and 1 year. At 10 min

30 min

and 60 min after surgery

the agitation during anesthesia recovery period was evaluated by pediatric anesthesia emergence delirium (PAED). Results: Compared with T0 to T2

the HR of control group decreased significantly from T3 to T6 (P<0. 05). From T1 to T6

the HR

Da-jvO2

CERO2

A-VGlu and A-VLac of the observation group were significantly lower than those of the control group (P<0. 05). The WISC-Ⅳ score in the observation group was significantly higher than that in the control group after surgery of 1 week and 3 months (P<0. 05). At 10 min

30 min

and 60 min after surgery

the PAED score of the observation group was significantly lower than that of the control group (P<0. 05)

the incidence of restlessness in the observation group was significantly lower than that in the control group (P<0. 05). Conclusion: Dexmedetomidine nasal drip combined with sevoflurane inhalation induction in children with interventional closure of congenital heart disease is helpful to reduce intraoperative cerebral oxygen metabolism

decrease cognitive impairment induced by cerebral ischemia and hypoxia

improve the quality of awakening

and has less hemodynamic impact.