|
|
|
| Application of Dexmedetomidine with Non-intravenous Route in Postoperative Analgesia in Pediatric Patients Undergoing Abdominal Surgery |
| CAO Xuefeng, ZHAO Liang, LIU Xudong, et al |
| The Affiliated Hospital of Chengde Medical University, Hebei Chengde, 067000, China |
|
|
|
|
Abstract Objective: To investigate the effect of dexmedetomidine intravenous administration on postoperative analgesia in pediatric patients undergoing abdominal surgery. Methods: 60 patients who were undergoing the general anesthesia for lower abdomen surgery were randomly devided into there groups, each group 20 cases. Patients in group B were received dexmedetomidine 1ug/kg nasal drops before operation 30min; Patients in group A, C were received volume normal saline nasal drops. The three groups were given atropine 0.01-0.02mg/kg, lidocaine 1mg/kg, propofol 2mg/kg, sevoflurane 6-8%, oxygen flow 2L/min, waiting for the eyelash reflex disappeared, placed the laryngeal mask, sevoflurane dropped to 1-2%. In group A and group B, 0.25% ropivacaine 1ml/kg was injected after the success of sacral block, group C was given 0.25% ropivacaine 1ml/kg+ dexmedetomidine 1ug/kg, sacral block was given total amount of 20ml cap. 1. Each patient general information respectively were record; 2. The time of operation, induction, extubation and anesthesia awake were recorded; 3. The adverse events such as bradycardia, delayed awakening, laryngismus, urine retention were and awakening period agitation score were recorded. 4. Postoperative 4, 8, 12, 16, 20, 24 hours analgesic score, sedation score and analgesia time were recorded. Results: 1. The general situation have no statistical significance (P>0.05); 2. The time of operation, extubation and anesthesia awake have no statistical significance (P>0.05), the induction time of B group are shorter than A and C groups (P＜0.05); 3. All the three groups have no hypoxemia, delayed awakening and urine retentionwere; Compared with group B and C, the emergence laryngismus and awakening period agitation score were higher in group A (P<0.05); the analgesia time were shorter, group C was the longest. 4. All the analgesic score of the three groups were less than 4 points, sedation score for 2-3 minute in postoperative 4 h. Compared with group A, analgesic and sedation score of the group B and C are lower in postoperative 8 h(P<0.05). Compared with group A and B, analgesic and sedation score of the group C were lower in postoperative 12, 16, 20h (P<0.05). There was no statistical significance in postoperative 24h (P>0.05). Conclusion: Intranasal dexmedetomidine (DEX) application used in pediatric anesthesia induction period undergoing the lower abdomen and lower extremity surgery could significantly reduce induction time and have early postoperative analgesia sedation. For caudal block, which received the ropivacaine mixed with 1ug/kg dexmedetomidine can prolonge analgesia calm times and reduce adverse reaction during anesthesia recovery period .
|
|
|
|
|
|
[1] Mather L, Mackie J. The incidence of postoperative pain in children[J].Pain ,1983,15(3):271~282.
[2] Afonson J, Reis F.Dexmedetomide: current role in anesthesia and intensive care[J].Rev Bras Anestesiol, 2012, 62(1): 118~133.
[3] 丛海涛,王惠琴,范正芬,等.不同剂量右美托咪定滴鼻在麻醉诱导前的应用比较[J].中国现代应用药学,2015,32(7).
[4] A kin A, O calan S , E smaoglu A , et al. The effect of caudal or intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine in children[J].Paediatric Anaesth,2010,20(4):350~355.
[5] Patel A, Davidson M, Tran MC, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy[J].AnesthAnalg,2010,111(4):1004~1010.
[6] She YJ, Zhang ZY, Song XR. Caudal dexmedetomidine decrease the required concentration of levobupivacaine for caudal block in pediatric patients: a randomized trial[J].Paediatr Anaesth,2013,233(12) :1205~1212.
[7] Weldon BC, Bell M, Craddock T. The effect of caudalanal gesiaonemergence agitation in children after sevofluranever sushalothane anesthesia[J].AnesthAnalg,2004,98(2):321~326. |
|
|
|
2017, Vol. 23 
