| Objective: To observe the effect of dexmedetomidine on intraoperative hemodynamics and analgesic effect in children undergoing elective high ligation surgery of indirect inguinal hernia before operation and the incidence of perioperative adverse reactions.To evaluate the analgesic effect and safety of dexmedetomidine in short-time surgery of pediatric anesthesia.Method: Ninety A total of 90 children aged 6-12 years with American College of Physicians(ASA)grade I-II undergoing elective surgery for indirect inguinal hernia were selected and divided into experimental(D)and control(C)groups using a randomized,double-blind,controlled method,with 45 patients in each group In both groups,inhalation combined with general anesthesia was used,and local infiltration of 0.2% ropivacaine 2 mg/kg surgical incision was given after surgery.Group D received dexmedetomidine premedication,dexmedetomidine 0.5 ug/kg diluted to 20 ml,3 ug/kg/h was intravenouslypumped within 10 min before anesthesia induction,and group C was control group,20 ml of normal saline was intravenously pumped within10 min before anesthesia induction.The anxiety score(Yale Preoperative Anxiety Scale: m-YPAS)was performed 1 day before operation(t0),when entering the operating room(t1),during induction(t2),2 hours after operation(t3)and 4 hours after operation(t4);the heart rate,systolic blood pressure(SBP)and diastolic blood pressure(DBP)were recorded at various time points when the children were admitted into the operating room(T0),when they were induced(T1),when the laryngeal mask was placed for 5 min(T2),when the operation started for 5 min(T3),when the laryngeal mask was removed for 5 min(T4),when they were admitted to the recovery room(T5)and when they were discharged from the recovery room(T6).Postoperative pain was assessed at 2 hours(T '0),4hours(T' 1),1 day(T '2),2 days(T' 3),1 week(T '4),and 1 month(T' 5)after surgery,respectively.Children were assessed for postoperative agitation when the aldrete score reached 9 in the anesthesia recovery room.Parents' satisfaction was assessed 1 day,1 week,and 1 month after surgery.The operation time(Ta),complete recovery time(Tb)in the recovery room,and adverse events of anesthesia were recorded in both groups?.Result:(1)There was no significant difference in gender,age,weight,operation time and other aspects between the two groups(P > 0.05).(2)Hemodynamic comparison: There were significant differences in SBP and DBP between group D and group C at T1,T2,T3,T4 and T5(P <0.05);HR had significant differences at T1,T2,T3,T4 and T5(P <0.05).(3)Anxiety score comparison: t2,t3,t4 had significant difference(P < 0.05);t0,t1 had no statistical difference(P > 0.05).(4)Postoperative pain scores: T'1,T'2,T'3 had significant difference(P < 0.05);T'0,T'4,T'5 had no significant difference(P > 0.05).(5)Postoperative restlessness score: There was significant difference between group D and group C(P <0.05);(6)Parental satisfaction score: There was significant difference in parental satisfaction score at 1 day after operation(P < 0.05)and no significant difference in parental satisfaction score at 1 week and 1 month after operation(P > 0.05);(7)Total operation time(Ta): there was no significant difference between the two groups(P > 0.05);Complete recovery time(Tb): the difference was statistically significant(P < 0.05).(8)Comparison of the incidence of postoperative adverse reactions: There were significant differences in cough/breathlessness,propofol injection pain,bradycardia and chills between the two groups(P < 0.05);there were no significant differences in hypotension and nausea and vomiting(P > 0.05).Conclusion:Preoperative dexmedetomidine injection has good safety and feasibility in the operation of indirect inguinal hernia in children.It can significantly reduce sympathetic tension,stabilize hemodynamics andenhance the analgesic effect of opioids during the operation.It also has anti-anxiety,reduce postoperative agitation,reduce the incidence of adverse reactions,and improve the satisfaction of family members when the children leave hospital. |
PDF Full Text Request