Résumé
Objective:To investigate the effect of dexmedetomidine on agitation and hemodynamics during the recovery period in children after sevoflurane anesthesia.Methods:A total of 120 pediatric patients with selective tonsillectomy and adenoidectomy admitted to Shaoxing Central Hospital from January 2019 to December 2020 were randomly divided into the control group and the observation group, with 60 cases in each group. Both groups were induced by sevoflurane inhalation, followed by endotracheal intubation with 0.6 mg rocuronium and 2 μg/kg fentanyl intravenous injection. The observation group received dexmedetomidine combined with sevoflurane to maintain anesthesia, while the control group received normal saline combined with sevoflurane to maintain anesthesia. Heart rate (HR) and mean arterial pressure (MAP) were recorded at four times: before anesthesia (T 0), endotracheal intubation (T 1), the beginning of surgery (T 2) and the end of surgery (T 3). The time of anesthesia, surgery, recovery and extubation were recorded. Pediatric anesthesia emergence delirium (PAED) score, faces pain scale (FPS) score, the incidence of agitation and postoperative special events were compared between the two groups. Results:There were no significant differences in operation time, anesthesia time, extubation time and recovery time between the two groups ( P>0.05). The levels of HR and MAP in the control group were increased at T 1, T 2, T 3, and were higher than those in the observation group, the differences were statistically significant ( P<0.05). The scores of FPS, PAED and the incidence of agitation in the observation group were lower than those in the control group: (2.32 ± 0.61) scores vs. (3.66 ± 0.85) scores, (6.88 ± 1.85) scores vs. (11.75 ± 3.03) scores, 13.33% (8/60) vs. 3.33% (2/60), the differences were statistically significant ( t = 9.92, 10.63, χ2 = 3.93, P<0.05). The incidences of postoperative treatment with propofol, analgesics and respiratory tract adverse events in the observation group were lower than those in the control group: 3.33%(2/60) vs. 13.33%(8/60), 5.00%(3/60) vs. 16.67% (10/60), 3.33%(2/60) vs. 15.00%(9/60), the differences were statistically significant ( χ2 = 3.93, 4.23, 4.90, P<0.05). Conclusions:Dexmedetomidine maintenance induction of anesthesia for sevoflurane anesthesia in children can effectively reduce the incidence of agitation in the period of recovery, and has little effect on hemodynamics, with high safety.