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目的探讨右美托咪定联合七氟烷对小儿眼科手术术后镇静的影响。方法选择2014年1月—2016年8月在安康市中医医院进行眼科手术的患儿200例,将其随机分为两组,每组100例,A组患儿接受七氟烷联合生理盐水术后镇静,B组患儿接受七氟烷联合右美托咪定术后镇静,比较两组患儿的手术情况以及术后VAS疼痛评分、Ramsay镇静评分以及PAED躁动评分,记录两组患儿术后不良反应的发生情况并进行统计学分析。结果两组患儿的手术时间差异不显著,B组患儿术后清醒较A组晚,差异有统计学意义(P<0.05)。B组患儿术后拔管质量评分低于A组,差异有统计学意义(P<0.05);且B组术后使用镇痛剂的患儿明显较A组少,差异有统计学意义(P<0.05)。T1、T2及T3时刻,B组患儿的VAS评分显著小于A组患儿,差异有统计学意义(P<0.05);T1及T2时B组患儿的Ramsay评分显著高于A组患儿,差异有统计学意义(P<0.05);B组患儿PAED评分明显低于A组,差异有统计学意义(P<0.05)。B组患儿术后恶心呕吐、呼吸抑制、术后躁动的发生率显著低于A组患儿,差异有统计学意义(P<0.05);且B组患儿术后发生不良反应的总发生率显著低于A组患儿,差异有统计学意义(P<0.05)。结论右美托咪定联合七氟烷用于小儿眼科手术术后镇静的临床疗效显著且安全性较好,可以显著缓解患儿苏醒期的躁动程度,降低患儿术后发生不良反应的发生率,值得临床推广应用。
Objective To investigate the effect of dexmedetomidine combined with sevoflurane on postoperative sedation in pediatric ophthalmic surgery. Methods From January 2014 to August 2016, 200 children undergoing ophthalmic surgery at Ankang Traditional Chinese Medicine Hospital were randomly divided into two groups (n = 100 in each group). Patients in group A received sevoflurane combined with saline After sedation, children in group B received sevoflurane combined with dexmedetomidine postoperative sedation. The operation conditions, postoperative VAS pain score, Ramsay sedation score and PAED restlessness score were compared between the two groups. After the occurrence of adverse reactions and statistical analysis. Results There was no significant difference in operative time between the two groups. The postoperative awake in group B was later than that in group A, and the difference was statistically significant (P <0.05). The quality of postoperative extubation in group B was lower than that in group A, the difference was statistically significant (P <0.05); and the use of analgesics in group B was significantly less than that in group A P <0.05). At T1, T2 and T3, the VAS score of children in group B was significantly less than that of children in group A (P <0.05). The Ramsay scores of children in group B at T1 and T2 were significantly higher than those in group A , The difference was statistically significant (P <0.05). The PAED score of children in group B was significantly lower than that of group A, the difference was statistically significant (P <0.05). The incidence of postoperative nausea and vomiting, respiratory depression and postoperative agitation in group B was significantly lower than that in group A (P <0.05), and the total incidence of postoperative adverse reactions in group B The difference was statistically significant (P <0.05). Conclusion Dexmedetomidine combined with sevoflurane for pediatric ophthalmic surgery after sedation has significant clinical efficacy and safety, can significantly ease the recovery of children with agitation and reduce the incidence of postoperative adverse reactions in children ,Worthy of clinical application.