Application of pre-injection of dexmedetomidine of different doses in pediatric intravenous general anesthesia without tracheal intubation

摘要

This study observed the clinical efficacy of pre-injection of dexmedetomidine of different doses before surgery and the adverse reactions during the recovery period in pediatric intravenous general anesthesia without tracheal intubation. Pediatric patients who received general anesthesia without tracheal intubation before surgery from January 2016 to March 2017 were randomly divided into four groups (n=30), and were respectively treated with intravenous pump infusion of loaded dexmedetomidine of high-dose (2.5 µg/kg), middle-dose (1.5 µg/kg) and low-dose (0.5 µg/kg), while the children in the control group received injection of normal saline in same dose. Then, the mean arterial pressure (MAP) at different time points (5 and 10 min after administration, after anesthesia and after surgery), heart rate, Ramsay sedation score changes and adverse reactions during recovery period of anesthesia of pediatric patients were compared among four groups. At 5 and 10 min after administration, Ramsay scores of high-dose group and middle-dose group were higher than that of the control group, and the differences had statistical significance (P<0.05). There was no significant difference in comparison of Ramsay scores between low-dose group and the control group. The MAP and heart rate after anesthesia and after surgery of pediatric patients with pump infusion of dexmedetomidine in the three groups were decreased significantly compared to those of the control group, and the differences had statistical significance (P<0.05). The incidence rate of adverse reaction of pediatric patients during the recovery period after pump infusion in the three groups and the control group was, respectively, 13/30, 8/30, 7/30 and 8/30, and the differences were statistically significant (P<0.05). The sedative effect and safety of pre-injection of dexmedetomidine in pediatric intravenous general anesthesia without tracheal intubation are promising, and the medium dosage can maximize the anesthetic effect with less side effects.