PDF(Pubmed)
Abstract：
The incidence of emergence delirium (ED) is higher in preschool children undergoing tonsillectomy and/or adenoidectomy. The purpose of this study was to determine the median effective dose (ED50) of dexmedetomidine (DEX) for the inhibition of ED in preschool children by using probit regression analysis. A total of 140 anesthesia records were retrieved and divided into seven groups based on the infusion rate of DEX: .2, .25, .3, .35, .4, .45, and .5 μg·kg-1·h-1. The Pediatric Anesthesia Emergence Delirium Scale (PAEDS) was used to assess ED in preschool children, and ED was defined as a PAEDS score ≥ 10. Probit regression analysis revealed that the ED50 and ED95 of DEX were .31 μg·kg-1·h-1 (95% CI: .29-.35) and .48 μg·kg-1·h-1 (95% CI: .44-.56), respectively. Probit(p) = -2.84 + 9.28 × ln (Dose), (χ2 = 1.925, P = .859). The PAEDS score was significantly increased in the ED group, and the rate of bradycardia was significantly decreased in the ED group compared with the without ED group (27.3% vs 54.1%, P = .02). DEX can effectively inhibit the ED in preschool children undergoing tonsillectomy and/or adenoidectomy, however, bradycardia was the main complication.
摘要：
在接受扁桃体切除术和/或腺样体切除术的学龄前儿童中，出现谵妄（ED）的发生率更高。本研究的目的是通过probit回归分析确定右美托咪定（DEX）抑制学龄前儿童ED的中位有效剂量（ED50）。总共检索了140份麻醉记录，并根据DEX的输注速度分为7组：.2、.25、.3、.35、.4、.45和.5μg·kg-1·h-1。小儿麻醉发生谵妄量表(PAEDS)用于评估学龄前儿童的ED,ED定义为PAEDS评分≥10。Probit回归分析表明，DEX的ED50和ED95分别为.31μg·kg-1·h-1（95％CI：.29-.35）和.48μg·kg-1·h-1（95％CI：.44-.56），分别。Probit(p)=-2.84+9.28×ln(剂量),(χ2=1.925,P=.859)。ED组PAEDS评分明显增高，与无ED组相比，ED组的心动过缓发生率显着降低（27.3％vs54.1％，P=.02）。DEX可以有效抑制学龄前儿童扁桃体切除术和/或腺样体切除术后的ED，然而,心动过缓是主要并发症。
