标题：右美托咪定滴鼻镇静术预防儿童牙科焦虑症的有效剂量分析

      作者：奚晓雁，肖宇，周淑辉    (广州市白云区第一人民医院手术室，广东 广州 510410)

      卷次： 2017年28卷8期

      【摘要】 目的 探讨右美托咪定滴鼻镇静术预防儿童牙科焦虑症的有效剂量。方法 选择我院2015年1月至2016年6月经改良儿童畏惧调查表—牙科分量表(改良中文版CFSS-DS)筛选的伴有牙科焦虑症拟实施开髓治疗的牙髓炎34例患儿作为研究对象，治疗前30 min对患儿实施右美托咪定滴鼻，滴鼻后30 min评估患儿的镇静评分(Ramsay)、术后评估患儿的Houpt评分，以Ramsay≥3分及Houpt评分≥5分作为阳性标准，采用改良Dixon序贯法寻找右美托咪定的半数有效剂量，初始剂量为2 μg/kg，增减剂量为0.1 μg/kg，直到出现7个横跨点，采用Probit概率单位回归法寻找右美托咪定预防儿童牙科焦虑症的半数有效剂量(CP50)、95%有效剂量(CP95)。结果 33例患儿完成本研究，经 Probit分析得出，右美托咪定滴鼻预防儿科焦虑症的CP50为 1.515 μg/kg，95%CI (1.403~1.600)，CP95的有效剂量为1.742 μg/kg，95%CI (1.638~2.288)。结论 术前30 min采用1.515 μg/kg滴鼻，可为伴有儿科焦虑症的牙髓炎患儿实施开髓手术提供良好的镇静效果，提升配合依从性。
      【关键词】 右美托咪定；滴鼻镇静术；牙科焦虑症；儿童；有效剂量
      【中图分类号】 R788 【文献标识码】 A 【文章编号】 1003—6350（2017）08—1260—03

Effective dose of dexmedetomidine nasal sedation in prevention of dental anxiety disorder in children.
XIXiao-yan, XIAO Yu, ZHOU Shu-hui. Operating Room, the First People's Hospital of Baiyun District of Guangzhou,Guangzhou 510410, Guangdong, CHINA
【Abstract】 Objective To explore the effective dose of dexmedetomidine as nasal drop for sedation in preven-tion of dental anxiety disorder in children. Methods From Jan. 2015 to Jun. 2016, 34 children with dental anxiety disor-der scheduled for open-pulp treatment were selected as the subjects of the study with modified Dental Subscale of theChildren's Fear Survey Schedule (modified Chinese version of CFSS-DS). 30 min before treatment, dexmedetomidinewas applied as nasal drop for intranasal sedation. Ramsay score 30 min after intranasal sedation and postoperativeHoupt score were evaluated. With Ramsay≥3 and Houpt score≥5 as positive standard, the median effective dose(CP50) and 95% effective dose (CP95) of dexmedetomidine in the prevention of dental anxiety in children were deter-mined by modified Dixon method and Probit regression analysis, with 2 μg/kg as initial dosage, at an increasing or decreas-ing dosage of 0.1 μg/kg until seven cross points. Results Among the 34 children, 33 completed the study. The CP50 of dex-medetomidine was 1.515 μg/kg, with 95%CI (1.403-1.600), and the CP95 was 1.742 μg/kg, with 95%CI (1.638-2.288).Conclusion 1.515 μg/kg dexmedetomidine for nasal sedation at 30 min before operation can provide a good sedative effectfor children with pulpitis associated with dental anxiety disorder and enhance compliance of the children.
      【Key words】 Dexmedetomidine; Nasal sedation; Dental anxiety; Children; Effective dose·论 著·doi:10.3969/j.issn.1003-6350.2017.08.019