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Objective:To evaluate the efficacy of auricular acupoint pressure therapy combined with intranasal dexmedetomidine for transthoracic echocardiography in pediatric patients.Methods:A total of 117 pediatric patients with congenital heart disease, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, aged 3-36 months, weighing 5-20 kg, scheduled for elective transthoracic echocardiography under outpatient sedation, were selected.Transthoracic echocardiography was performed under sedation using intranasally administered dexmedetomidine or using auricular acupoint pressure therapy combined with intranasal dexmedetomidine.The interval between the two sedation methods was at least 1 week.Intranasal dexmedetomidine: Dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.Intranasal dexmedetomidine combined with auricular acupoint pressure: auricular acupressure with Wang Bu Liu Xing (semen vaccariae) seeds was used at the auricular acupoints.After each acupoint was rubbed for about 1 min, dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.After the examination, auricular acupoint pressure therapy was continued at home, and pressing-rubbing at the acupoints was manipulated for 3 times daily, one of which was performed at 30 min before going to bed, for 3 consecutive days.When the University of Michigan Sedation Scale score≥2 and body movement score ≥2 within 30 min after giving dexmedetomidine, sedation was considered to be successful.The onset time of sedation, examination time, waiting time, recovery time and the success of sedation were recorded.The incidence of adverse reactions such as bradycardia, hypotension, hypertension, hypoxemia, nausea and vomiting, respiratory depression, restlessness, hyperactivity, action imbalances and allergic reaction were recorded within 24 h after administration of dexmedetomidine.Time to recovery and improvement of sleep quality at night were recorded.Results:Compared with intranasal dexmedetomidine, the successful rate of sedation and incidence of improvement of sleep quality at night were significantly increased ( P<0.05), and no significant change was found in adverse reactions using intranasal dexmedetomidine combined with auricular acupoint pressure ( P>0.05). Conclusion:Intranasal dexmedetomidine combined with auricular acupoint pressure therapy can increase the successful rate of sedation and improve the sleep quality at night in pediatric patients undergoing transthoracic echocardiography when compared to intranasal dexmedetomidine.
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Objective To evaluate the effects of different fluid therapy protocols on postoperative nausea and vomiting (PONV) in pediatric patients undergoing ambulatory surgery.Methods A total of 160 pediatric patients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 3-7 yr,weighing 14-24 kg,with body mass index ＜30 kg/m2,undergoing elective lower abdominal ambulatory surgery,were randomized into Ⅰ and Ⅱ groups (n=80 each) using a random number table method.Lactated Ringer's solution 10 ml · kg-1 · h-1 and 30 ml · kg-1 · h-1 were intravenously infused in group Ⅰ and group Ⅱ,respectively.Ibuprofen 20 mg/kg was given orally after operation to maintain Face Legs Activity Cry Consolability score ＜4.The development of PONV and thirst and requirement for antiemetics was recorded within 24 h postoperatively.The time of first PONV,time of first thirst and score for satisfaction of family members were also recorded.Results Compared with group Ⅰ,the incidence of PONV and thirst was significantly decreased,the time of first requirement for antiemetics and time of first thirst were prolonged,and the score for satisfaction of family members was increased (P＜ 0.05),and no significant change was found in the requirement for antiemetics in group Ⅱ (P＞0.05).Conclusion Intravenously infusing fluid 30 ml · kg-1 · h-1 can decrease the occurrence of PONV when compared with intravenously infusing fluid 10 ml · kg-1 · h-1 in pediatric patients undergoing ambulatory surgery.
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Objective To determine the appropriate dosage of parexoxib sodium for postoperative analgesia in different age children with day surgery.Methods One hundred and eighty ASA Ⅰ children aged 1-12 yr scheduled for day surgery undergoing sevoflurane anesthesia combined with lateral inguinal regional blockade were divided into 3 groups according to age ( n =60 each):group 1-3 yr (group Ⅰ ),group 4-6 yr (group Ⅱ ) and group 7-12 yr (group Ⅲ).Eeach group was randomly divided into 2 sub-groups( n =30): parecoxib sodium 0.5 mg/kg (sub-group A) and parecoxib sodium 1.0 mg/kg (sub-group B).Sub-groups A and B received iv injection of paracoxib sodium 0.5 or 1.0 mg/kg respectively immediately at skin incision.Analgesic effect was evaluated by FLACC score (group Ⅰ ),CHEOPS score (group Ⅱ ) and VAS scroe (group Ⅲ) at 6(T1 ),12(T2 )and 24 h (T3)after operation.The effective analgesia was defined as FLACC score≤3,CHEOPS score≤7 or VAS score≤ 3.Side effects were also observed.Results Compared with sub-group B,FLACC score was significantly increased at T1 in sub-group Ⅰ -A ( P ＜ 0.01 ).There was no significant difference in CHEOPS score or VAS score between sub-groups Ⅱ -A and Ⅱ -B,and between sub-groups Ⅲ-A and Ⅲ-B (P ＞ 0.05).The incidence of effective analgesia was 97％ in group Ⅰ (93％ in group sub-group Ⅰ -A,100％ in sub-group Ⅰ -B),100％ in group Ⅱ and 93％ in group Ⅲ (97％ in sub-group Ⅲ-A,90％ in sub-group Ⅲ-B).There was no significant difference in the incidence of side effect between sub-groups Ⅰ -A and Ⅰ -B,between sub-groups Ⅱ -A and Ⅱ -B,and between sub-groups Ⅲ-A and Ⅲ-B ( P ＞ 0.05).Conclusion Parecoxib sodium 1.0 or 0.5 mg/kg can be used in postoperative analgesia in children aged 1-3 yr or 4-12 yr with day surgery respectively.