关键词: 右美托咪定, 日间手术, 术后躁动, 七氟烷

Abstract: ［Abstract］ Objective To compare the effects of intranasal dexmedetomidine and intravenous dexmedetomidine on emergence agitation （EA） after sevoflurane anaesthesia in pediatric ambulatory orthognathic surgery. Methods In this study，135 children，1-6 years of age，undergoing sevoflurane anaesthesia were assigned to three groups which receiving either intravenous dexmedetomidine 1 μg/kg after induction （Group VD），intranasal dexmedetomidine 1 μg/kg 15 min before induction （Group ND）， or saline （Group C）. The severity of EA were evaluated with the Paediatric Anaesthesia Emergence Delirium （PAED） scale and pain were evaluated with FLACC scale every 5 min after surgery. The HR and BP were record at time points：before induction （T0），after induction （T1）， beginning of surgery （T2），being operated （T3） and woke up （T4）. And the time to recovery and PACU stays，incidence of nausea/vomiting，breath depression and bradycardia were assessed. Results The incidence of EA in Group VD and Group ND were lower than Group C（P<0.01）. The HR at time T2 and T3 in Group ND was significantly lower than that in Group VD and Group C（P<0.01），and the HR at time T3 was lower in Group ND than Group C（P<0.05）. Recovery time in Group ND and Group VD weres longer than in Group C（P<0.01）. The differences in time of PACU stays and the highest pain score between the 3 groups were considered clinically insignificant. Four children in Group VD required atropine treatment for bradycardia. Conclusion Both intranasal dexmedetomidine and intravenous dexmedetomidine comparably reduced EA after sevoflurane anaesthesia in pediatric pediatric ambulatory orthognathic surgery. Intranasal dexmedetomidine provide more acceptable heart rate during the surgery.

Key words: dexmedetomidine, ambulatory surgery, emergence agitation, sevoflurance