Effects of different doses of dexmedetomidine nasal drops on stress response and agitation during recovery in children with groin hernia under sevoflurane anesthesia

doi:10.3877/cma.j.issn.1674-392X.2020.02.014

Abstract

Abstract:

Objective

To analyze the effect of different doses of dexmedetomidine nasal drops on stress response and agitation in recovery period in children with hernia under sevoflurane anesthesia.

Methods

175 cases of pediatric hernia were divided into group A (n=57), group B (n=61) and group C (n=57) according to simple random method, and 1.0 μg/kg, 1.5 μg/kg and 2.0 μg/kg dexmedetomidine were given nasal drops, respectively. The recovery time, hemodynamics, stress response index, agitation score at different time points, incidence rate of agitation and other adverse reactions in each group were compared.

Results

The awakening time of group A was lesser than that of group B and group C, and the awakening time of group B was lesser than that of group C (P<0.05). The heart rate (HR) and mean arterial pressure (MAP) of the three groups increased immediately after surgery and immediately after removal of the laryngeal mask compared with that before nasal drops. The HR and MAP of group A were higher than those of group B and group C (P<0.05), immediately after the operation, the indicators of stress response in all three groups were increased compared with that before the operation, and group A was higher than group B and group C (P<0.05). There was no significant difference in HR, MAP and stress response index between group B and group C (P>0.05). Immediately after awakening, at 5 min after awakening and 15 min after awakening, the agitation score of group A were higher than those of group B and group C (P<0.05), and there was no statistical significance between group B and group C (P>0.05). The incidence of agitation and cough in group A was higher than that in group B and group C, while the incidence of nausea and vomiting in groups A and B was lower than that in group C (P<0.05).

Conclusion

1.5 μg/kg dexmedetomidine nasal drops are more suitable for pediatric hernia surgery under sevoflurane anesthesia. It can maintain the stability of hemodynamics, reduce stress response and agitation during recovery period, and do not increase the incidence of adverse drug reactions.

Key words: Hernia, inguinal, Child, Sevoflurane, Different doses, Dexmedetomidine nasal drops, Stress reaction, Agitation during awakening period

Peng Jiang, Zhiqi Hou, Dexing Luo. Effects of different doses of dexmedetomidine nasal drops on stress response and agitation during recovery in children with groin hernia under sevoflurane anesthesia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(02): 150-154.

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Figures/Tables 4

References 18

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组别	例数	心率(次/min)			平均动脉压(mmHg)
组别	例数	滴鼻前	手术开始即刻	拔喉罩即刻	滴鼻前	手术开始即刻	拔喉罩即刻
A组	57	86.00±8.40	92.65±9.95^a	98.81±9.90^a	81.74±11.36	95.65±9.70^a	97.21±9.15^a
B组	61	88.00±9.91	88.87±8.29^ab	92.29±9.66^ab	80.85±10.07	87.39±10.03^ab	84.97±10.04^ab
C组	57	86.47±8.13	87.98±10.49^ab	90.60±9.28^ab	80.93±8.77	87.16±11.30^ab	84.33±10.66^ab
F值	?	0.829	3.923	11.645	0.137	13.791	30.513
P值	?	0.438	0.022	<0.001	0.872	<0.001	<0.001

组别	例数	心率(次/min)			平均动脉压(mmHg)
组别	例数	滴鼻前	手术开始即刻	拔喉罩即刻	滴鼻前	手术开始即刻	拔喉罩即刻
A组	57	86.00±8.40	92.65±9.95^a	98.81±9.90^a	81.74±11.36	95.65±9.70^a	97.21±9.15^a
B组	61	88.00±9.91	88.87±8.29^ab	92.29±9.66^ab	80.85±10.07	87.39±10.03^ab	84.97±10.04^ab
C组	57	86.47±8.13	87.98±10.49^ab	90.60±9.28^ab	80.93±8.77	87.16±11.30^ab	84.33±10.66^ab
F值	?	0.829	3.923	11.645	0.137	13.791	30.513
P值	?	0.438	0.022	<0.001	0.872	<0.001	<0.001

组别	例数	皮质醇(ng/ml)		去甲肾上腺素(ng/ml)		醛固酮(mg/L)
组别	例数	术前	手术开始即刻	术前	手术开始即刻	术前	手术开始即刻
A组	57	98.65±11.64	169.68±25.47^a	65.13±8.83	89.89±10.13^a	0.181±0.018	0.340±0.055^a
B组	61	96.04±12.76	124.17±19.61^ab	67.29±7.36	76.72±11.50^ab	0.181±0.019	0.234±0.068^ab
C组	57	99.98±11.01	128.87±22.76^ab	67.24±7.93	76.14±9.59^ab	0.186±0.018	0.241±0.064^ab
F值	?	1.713	70.555	1.352	31.768	1.449	51.741
P值	?	0.183	<0.001	0.262	<0.001	0.238	<0.001

组别	例数	皮质醇(ng/ml)		去甲肾上腺素(ng/ml)		醛固酮(mg/L)
组别	例数	术前	手术开始即刻	术前	手术开始即刻	术前	手术开始即刻
A组	57	98.65±11.64	169.68±25.47^a	65.13±8.83	89.89±10.13^a	0.181±0.018	0.340±0.055^a
B组	61	96.04±12.76	124.17±19.61^ab	67.29±7.36	76.72±11.50^ab	0.181±0.019	0.234±0.068^ab
C组	57	99.98±11.01	128.87±22.76^ab	67.24±7.93	76.14±9.59^ab	0.186±0.018	0.241±0.064^ab
F值	?	1.713	70.555	1.352	31.768	1.449	51.741
P值	?	0.183	<0.001	0.262	<0.001	0.238	<0.001

组别	例数	躁动评分
组别	例数	苏醒即刻	苏醒后5 min	苏醒后15 min
A组	57	2.70±0.22	2.88±0.22	2.86±0.24
B组	61	1.62±0.22^a	1.71±0.24^a	1.62±0.19^a
C组	57	1.60±0.23^a	1.73±0.25^a	1.61±0.21^a
F值	?	460.667	454.605	639.942
P值	?	<0.001	<0.001	<0.001

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