雾化芬太尼、咪达唑仑和右美托咪定在门诊儿童牙科手术中作为镇静前用药的比较:一项随机双盲研究

M. Medhat, Sara Abd Elnaby
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引用次数: 1

摘要

背景幼儿手术前的术前时间是创伤性的。父母分离和针头注射增加术前焦虑。儿童术前镇静通常经直肠、口腔、舌下和鼻内给药,患者接受程度不同。雾化药物是一种相对容易设置的镇静替代方法。材料与方法将39例2 ~ 6岁门诊牙科手术患儿随机分为3组(每组13例);F组患者术前30 min雾化芬太尼2 μg/kg, M组患者术前30 min雾化咪达唑仑0.2 mg/kg, D组患者术前30 min雾化右美托咪定2 μg/kg。结局指标包括镇静发作、父母分离、面罩诱导耐受性、静脉插管反应和术前血流动力学变化(收缩压、舒张压和心率)。结果与右美托咪定相比,芬太尼雾化组和咪达唑仑雾化组患儿镇静起效早。在亲子分离中,芬太尼和右美托咪定诱导质量优于咪达唑仑。静脉插管评分以芬太尼为前用药效果最好。结论芬太尼雾化剂量为2 μg/kg比雾化咪达唑仑0.2 mg/kg和雾化右美托咪定2 μg/kg起效早、镇静作用深、易分离、作用时间短,在用药前效果优于雾化剂量为2 μg/kg的咪达唑仑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of nebulized fentanyl, midazolam, and dexmedetomidine as a sedative premedication in outpatient pediatric dental surgeries: a randomized double-blind study
Background The preoperative time is traumatic for young children undergoing surgery. Parental separation and needle injection increase preoperative anxiety. Preoperative sedation in children is usually administered via the rectal, oral sublingual, and intranasal routes with different degrees of patient acceptance. Nebulized drug is an alternative method of sedation that is relatively easy to set up. Materials and Methods Thirty nine pediatric patients (2–6) years old scheduled for outpatient dental surgeries were randomly allocated in three groups (13 patients each); group (F) received nebulized fentanyl 2 μg/kg 30 min before surgery, group (M) received nebulized midazolam 0.2 mg/kg 30 min before surgery and group (D) received nebulized dexmedetomidine 2 μg/kg 30 min before surgery. The outcome measures included onset of sedation, parental separation, tolerance to mask induction, reaction to intravenous cannulation and preoperative hemodynamic changes (systolic blood pressure, diastolic blood pressure and heart rate). Results Children who received nebulized fentanyl and nebulized midazolam had early onset of sedation as compared to dexmedetomidine. In child-parent separation, quality of induction was better with fentanyl and dexmedetomidine as compared to midazolam. Intravenous cannulation score was best achieved with fentanyl as premedication. Conclusion Nebulized fentanyl in a dose of 2 μg/kg is better than nebulized midazolam 0.2 mg/kg and nebulized dexmedetomidine 2 μg/kg as far as premedication is concerned because of its early onset of action, deeper levels of sedation, easy child-parent separation and shorter duration of action.
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