摘要： 目的：探讨鼻腔喷雾右美托咪定在下颌第三磨牙拔除术中的临床应用价值。方法：30例需拔除下颌第三磨牙的患者随机分为右美托咪定组（DEX组）和对照组（C组），每组15例。DEX组鼻腔喷雾1.5 μg/kg右美托咪定，C组鼻腔喷雾生理盐水，30 min以后实施局部麻醉，拔出下颌第三磨牙。每10 min记录患者的收缩压（SBP）、心率（HR）、血氧饱和度（SpO2)，评估患者的改良OAA/S评分，同时记录注射局麻药时的VAS评分。结果：DEX组的SBP和HR在鼻腔喷雾给药后的30～60 min出现一定程度下降，与C组比较，差异有统计学意义（P<0.05）。DEX组在给药后20～60 min时出现镇静作用，差异有统计学意义（P<0.05）。注射局麻药时两组患者均感到轻微疼痛，差异无统计学意义（P>0.05）。结论：鼻腔喷雾右美托咪定1.5 μg/kg，能够有效、安全且便捷地应用于健康成人下颌第三磨牙拔除术中的镇静，缓解患者的焦虑情绪。

关键词: 下颌第三磨牙；  , 右美托咪定；  , 鼻腔喷雾；  , 拔牙

Abstract: Objective: To evaluate the effect of atomized dexmedetomidine for sedation in patients undergoing mandibular third molar removal. Methods: Thirty patients underwent mandibular third molar removal were randomly assigned into 2 groups: group DEX, nasal spray with 1.5 μg/kg atomized dexmedetomidine; group C, nasal spray with normal saline. Local anaesthesia was injected 30 min after nasal spray. During the process of extraction, SBP, HR and SpO2 were recorded at every 10 min period. Sedation status was measured at every 10 min with a modified Observer's Assessment of Alertness/Sedation (OAA/S) scale. Pain from local anaesthesia infiltration was rated on a scale from 0 to 10. Results: Group DEX patients displayed decreased SBP and HR at 30-60 min after intranasal dexmedetomidine, which were significantly different from group C（P<0.05）. Sedation values in group DEX were significantly different from group C at 20-60 min after intranasal drug administration（P<0.05）. No significant differences were observed between the groups in terms of the pain score during LA injection. Conclusion: Intranasal administration of 1.5 μg/kg atomized dexmedetomidine was clinically effective, safe and convenient for the sedation of healthy patients and relief patients' anxiety undergoing mandibular third molar extraction.

Key words:  mandibular third molar removal, dexmedetomidine, intranasal, extraction

中图分类号: 

• R782.11

• R614.3