The Observation Of The Effect Of Dexmedetomidine On Postoperative Agitation In Children With Tonsillectomy And Adenoidectomy

Objective:To evaluate application value of dexmedetomidine in preventing postoperativeagitation of children with tonsillectomy and adenoidectomy.Methods:Forty pediatric patients ASA Ⅰ level,2~7years old,15~28kg body weightwho underwent geneal anesthesia with tonsillectomy and adenoidectomy wererandomly divided into two groups, namely dexmedetomidine group (D group, n=20)and propofol group (B group, n=20).Group D was pumped DEX continuously with1ug/kg rate before anesthesia induction, and finished in10min.Then it continued tobe pumped DEX with0.2~0.7u g/(kg.h) after anesthesia induction intubation, untilit was stopped injection about10min before the end of surgery. During anesthesiainduction we given intravenous injection midazolam0.1mg/kg, propofol2.0mg/kg,fentanyl0.002~0.003mg/kg, suitable atracurium0.1mg/kg,and maintainedanesthesia with fentanyl, propofol, atracurium during the operation. B group wasgiven0.9%sodium chloride injection of the same speed and capacity,and the samewith group D during anesthesia induction and maintenance.we monitored routinelyECG, MAP, HR, SpO2and PetCO2during the operation,and recorded basic valuesof the two groups (T0), the instant of intubation (T1), the instant of installing themouth gag(T2), the instant of extubation (T3),3min after extubation (T4), meanarterial pressure (MAP), heart rate (HR).we recorded the incidence ofvomiting,drowsiness and pain during the recovery period and anesthesia drug dosage, and evaluated and recorded agitation condition of the postoperation in twogroups of pediatric patients by the way of a four point system.Results:Preoperative general conditions of two groups of patients had no statisticalsignificance (P>0.05).MAP and HR of two groups in T0had no significantdifference. HR of D group was significantly lower than that of B group (P <0.05) ateach time point of T1-T4, but MAP of D group was significantly lower than that ofB group (P <0.05) in T1, T3.The total applied dose of propofol in patients of groupD was significantly less than that of B group during the operation,and the differencewas statistically significant (P <0.05). For the observation of agitation in two groupsof pediatric patients: that of D group decreased significantly compared to B group(P<0.05), as far as the incidence of vomiting and drowsiness was compared,differences have no statistical significance (P>0.05).Conclusion:The combined utilization of dexmedetomidine in the pediatric patients withtonsillectomy and adenoidectomy can significantly reduce the incidence ofpostoperative agitation and reduce the consumption of propofol,it aiso maintain thehemodynamic stability in the perioperative period, make the security better.