| 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（ASA）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2 μg/kg、雾化吸入右美托咪啶2 μg/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，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 |
| 关键词: 右美托咪定 雾化吸入 幼儿 影像学检查 静脉穿刺 |
| DOI：doi:10.13407/ j.cnki.jpp.1672.108X.2021.09.019 |
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| 基金项目: |
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| Sedative Effects of Nebulized Inhalation of Dexmedetomidine before CT/MRI Examination in Children |
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| Abstract: |
| 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, ASA I~II) who underwent CT/MRI in our hospital from Aug. 2018 to Jan. 2019 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 2 μg/kg, and atomized inhalation of dexmedetomidine 2 μg/kg were administered for sedation. Onset time, examination time, sedation time, rate of sedation failure, incidence of adverse drug reactions, Groningen distress score (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. |
| Key words: dexmedetomidine nebulised inhalation children imaging examination venipuncture |
