Objective:To observe the anesthesia advantage of intranasal dexmedetomidine( DEX) ap-plication used in pediatric anesthesia induction period undergoing the lower abdomen and lower extremity sur-gery. Methods:We enrolled 40 patients who were undergoing the general anesthesia for lower abdomen and lower extremity elective surgery, which were randomly devided into A( n=20) and B( n=20) groups , in-tranasal dexmedetomidine 1ug/kg 30min before operation in group A, physiological saline instead in group B. 1mg /kg propofol was infused intravenously every time who could not smoothly into the operating room of chil-dren as well as the induced intolerance to oxygen mask of children. 1. Record each patient general information respectively;2. Sedation status when separating from their parents and mask induction scores were assessed, the dose of propofol during induction period were recorded ; 3. Mean arterial pressure ( MAP ) , Heart rate (HR) and saturation of pulse oximetry (SPO2) were recorded at different time points as follows:baseline val-ues were recorded before intranasal dexmedetomidine ( T0) , transferred into operation room ( T1) , immedi-ately inserting the laryngeal mask ( T2) , at 5 min after intubation( T3) and operation immediately ( T4);4. The time of operation, induction , extubation and anesthesia awake were recorded;5. The adverse events such as hypoxemia , bradycardia , reflection of tussis , laryngismus and tachycardia were recorded. Results:1.The general situation have no statistical significance ( P>0.05);2. Compared with group B, sedation status when separating from their parents are higher in A group , the consumption of propofol are less than B group , mask induction scores are lower in A group(P<0.05);3. The influence of two groups on the MAP, HR and SPO2 are difference (P<0.05), the A group was relatively stable than the B group. Compared with T0 , the MAP, HR and SPO2 of group A at all points are no difference ( P>0.05) , the MAP of group B at T1 are lower, at T2 are higher significantly ( P<0.05) . The HR of group B at T1,4 are higher significantly ( P<0.05) . The SPO2 of group B at T1 are lower significantly ( P<0.05) . 4. The time of operation, extubation and anesthesia awake have no statistical significance ( P>0.05) , the induction time of A group are shorter than B group( P<0.05);5. The two groups have no hypoxemia and bradycardia , compared with group B, the emergence reflection of tussis , laryngismus and tachycardia are lower in group A( P<0.05) . Conclusion:Intranasal dexmedetomidine ( DEX) application used in pediatric anesthesia induction period undergoing the lower abdomen and lower ex-tremity surgery could significantly reduce induction time and reduce adverse reaction, increase comfort andsafety of children in the transfer process, it has a relatively stable hemodetomidine during induction.%目的:研究右美托咪定滴鼻给药在儿科下腹及下肢手术中麻醉诱导期的应用优势.方法:收集我院儿科拟在全麻下行下腹及下肢择期手术的患儿40例,随机分为实验组和对照组,每组各20例.实验组患儿于术前30min右美托咪定1ug/kg滴鼻,对照组患儿等容积生理盐水滴鼻,30min后不能顺利转入手术室的患儿以及诱导时不能耐受面罩吸氧的患儿每次给予丙泊酚1mg/kg.①记录患儿的一般资料;②离开父母时的镇静评分,诱导期给予丙泊酚的剂量,面罩吸氧的耐受评分;③记录患儿滴鼻前(T0),入室时(T1),插入喉罩即刻(T2),插入喉罩后5min(T3),手术开始时(T4)的平均动脉压(MAP),心率(HR),血氧饱和度(SPO2);④记录手术时间,诱导时间,拔喉罩时间,苏醒时间;⑤记录诱导时是否出现低氧血症,心动过缓,呛咳反射,置入喉罩时出现喉痉挛及心动过速的现象.结果:与对照组比较,应用右美托咪定滴鼻,能够显著降低患儿离开父母时镇静情绪评分,后期应用丙泊酚的剂量低于对照组(P<0.05).与对照组比较,MAP、HR和SPO2等在麻醉过程中,比较平稳,差异有统计学意义.在对照组麻醉过程中,进手术室之前(T0)比较,T1点在MAP明显降低,T2明显升高(P<0.05),T1、T4点HR明显升高(P<0.05),T1在SPO2明显降低(P<0.05).实验组诱导期短于对照组(P<0.05),与对照组比较,在插管过程中发生呛咳反应和心动过速的频率少于对照组(P<0.05).结论:右美托咪定滴鼻给药应用于儿科下腹及下肢手术,患儿可以安静合作的进入手术室并快速平稳完成诱导过程,减少了丙泊酚的用量,减少了不良反应的发生.
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