Comparison And Observation On Infantile Dysphoria During Revival Period In Full An-esthesia Prevented By Dexmedetomidine And Low-dose Ketamine

Objective: To observe the effects and safeties of dexmedetomidine andlow-dose ketamine used to prevent dysphoria during revival period in fullanesthesia in children undergoing adenotonsillectomy，then the preventiveeffects of the two drugs were compared and observed.Methods: Sixty children who received adenotonsillectomy under generalanesthesia were randomly divided into three groups: dexmedetomidine group(D group)，low-dose ketamine group (K group)，and normal saline group (Sgroup)，20children in each group. After endotracheal intubation underanesthesia induction，the children in D group were treated with pump infectionof dexmedetomidine (1μg/kg，volume:10ml)，the children in K group weretreated with pump infection of low-dose ketamine (0.3mg/kg，volume:10ml)，and the children in S group were treated with pump infection of normalsaline (10ml)，the operation was completed within10minutes in the threegroups. In the three groups，propofol and remifentanil were used to sustainanesthesia; blood pressure， cardiogram， heart rate and oxyhemoglobinsaturation were monitored continuously. the revival time (from stopinganesthetic to opening eyes by a call)，duration of stay in resuscitation room，postoperative dysphoria during revival period， and complications wereobserved.Monitoring and recording the HR and MBP changes when into therecovery room (T1), before extubation (T2), extubation (T3), after extubation2min (T4). Observed restlessness score、incidence and degree of agitation occursof anesthesia dysphoria during revival period, surgery time, anesthesia time,extubation time, using five restlessness score grading (>4points restlessness). Observed in children with recovery time, recovery room stay and restlessness,vomiting, cough, glossocoma and other adverse events. Record after extubation1~4h Ramsay sedation score.Results: The incidence rates of postoperative dysphoria in D group，Kgroup，and S group were5.0%，35.5%，and80.0%，respectively，there wasstatistically significant difference among the three groups (P <0.05); comparedS group，1-4-hour Ramsay score in D group and K group increasedsignificantly (P <0.05)，the number of children with smooth sleeping in Dgroup was significantly higher than those in K group and S group.Conclusion: Both dexmedetomidine and low-dose ketamine can preventinfantile dysphoria during revival period， and dexmedetomidine is moreef-fective and safer.