关键词: 右美托咪定, 术前滴鼻, 扁桃体手术, 儿童

Abstract: Objective To observe the safety effect of different doses of dexmedetomidine preoperative intranasal medication in children tonsillectomy. Methods Sixty children for tonsillectomy were randomly assigned into the H, L and C groups(n=20). Group H was given dexmedetomidine 2 μg/kg(adding saline to 0.3 mL), group L was given dexmedetomidine 1 μg/kg(adding saline to 0.3 mL)and group C was given physiological saline 0.3 mL, 40 min before the induction of anesthesia, respectively. The sedation, separated state, hemodynamics, breath, extubation time, PACU stay, as well as side effects were observed among groups. The serum levels of inflammatory cytokine TNF-α and IL-6 after extubation immediately(T₁), postoperative 4 h(T₂), postoperative 12 h(T₃)and postoperative 24 h(T₄)were measured, respectively. Results The sedation and separated state in groups H and L were much better than those in group C. BP and HR in groups H and L were lower than those in group C at different time points(P<0.001). Oxygen saturation, extubation time and PACU stay time showed no significant difference among groups(P>0.05). The incidences of adverse events in groups H and L, such as postoperative agitation and choking cough, were lower than those in group C(P=0.024 & P=0.025). The plasma levers of TNF-α and IL-6 in groups H and L were lower than those in group C(P<0.001)at T₁, T₂, T₃ and T₄. Conclusion Dexmedetomidine preoperative intranasal medication can improve children sedation level, improve parent-child separation state, maintain stable hemodynamics with no respiratory depression and less adverse events, reduce perioperative inflammatory factor release, and increase security. Dexmedetomidine 2 μg/kg provides more stable circulation by reducing inflammatory cytokine release.

Key words: Preoperative intranasal, Tonsillectomy, Dexmedetomidine, Children