鼻腔喷雾右美托咪定在下颌第三磨牙拔除术中的应用

摘要

目的：探讨鼻腔喷雾右美托咪定在下颌第三磨牙拔除术中的临床应用价值。方法：30例需拔除下颌第三磨牙的患者随机分为右美托咪定组（DEX组）和对照组（C组），每组15例。DEX组鼻腔喷雾1.5μg/kg右美托咪定，C组鼻腔喷雾生理盐水，30 min 以后实施局部麻醉，拔出下颌第三磨牙。每10 min 记录患者的收缩压（SBP）、心率（HR）、血氧饱和度（SpO2)，评估患者的改良OAA/S评分，同时记录注射局麻药时的VAS评分。结果：DEX组的SBP和HR在鼻腔喷雾给药后的30～60 min出现一定程度下降，与C组比较，差异有统计学意义（P<0.05）。 DEX 组在给药后20～60 min时出现镇静作用，差异有统计学意义（P<0.05）。注射局麻药时两组患者均感到轻微疼痛，差异无统计学意义（P>0.05）。结论：鼻腔喷雾右美托咪定1.5μg/kg，能够有效、安全且便捷地应用于健康成人下颌第三磨牙拔除术中的镇静，缓解患者的焦虑情绪。%Objective: To evaluate the effect of atomized dexmedetomidine for sedation in patients undergoing mandibular third molar removal. Methods: Thirty patients underwent mandibular third molar removal were randomly assigned into 2 groups:group DEX, nasal spray with 1.5 μg/kg atomized dexmedetomidine;group C, nasal spray with normal saline. Local anaesthesia was injected 30 min after nasal spray. During the process of extraction, SBP, HR and SpO 2 were recorded at every 10 min period. Sedation status was measured at every 10 min with a modified Observer's Assessment of Alertness/Sedation (OAA/S) scale. Pain from local anaesthesia infiltration was rated on a scale from 0 to 10. Results: Group DEX patients displayed decreased SBP and HR at 30-60 min after intranasal dexmedetomidine, which were significantly different from group C(P<0.05). Sedation values in group DEX were significantly different from group C at 20-60 min after intranasal drug administration (P<0.05). No significant differences were observed between the groups in terms of the pain score during LA injection. Conclusion: Intranasal administration of 1.5 μg/kg atomized dexmedetomidine was clinically effective, safe and convenient for the sedation of healthy patients and relief patients' anxiety undergoing mandibular third molar extraction.