A total of 118 children who planned to undergo fiberoptic bronchoscopy from September 2018 to February 2021 were enrolled. They were divided into a control group (n=60) and an observation group (n=58) using a random number table. The observation group received intravenous pumping of
dexmedetomidine hydrochloride (2 μg/mL) at 1 μg/kg and then
intravenous injection of
midazolam at 0.05 mg/kg, followed by
dexmedetomidine hydrochloride pumped intravenously at 0.5-0.7 μg/(kg·h) 10 minutes later to maintain
anesthesia. The control group was given intravenous pumping of
propofol at 2 mg/kg and then
intravenous injection of
midazolam at 0.05 mg/kg, followed by
propofol pumped intravenously at 4-6 mg/(kg·h) 10 minutes later to maintain
anesthesia. Fiberoptic bronchoscopy was performed after the children were unconscious. Heart rate (HR), respiratory rate, blood oxygen saturation, and mean arterial pressure (MAP) were recorded before inserting the
bronchoscope (T0), at the time of inserting the
bronchoscope (T1), when the
bronchoscope reached the glottis (T2), when the
bronchoscope reached the carina (T3), and when the
bronchoscope entered the bronchus (T4). The intraoperative peak airway pressure (Ppeak), examination time, degree of sedation, extent of
amnesia, incidence of adverse reactions, postoperative awakening time, and postoperative agitation score were also recorded.
RESULTS: Compared with the control group, the observation group had significantly decreased MAP at T1 to T4 and HR at T1 to T3 (P<0.05). Compared with that at T0, MAP was significantly increased at T1 to T4 in the control group and at T3 in the observation group (P<0.05). HR was significantly higher at T1 to T3 than at T0 (P<0.05). Compared with the control group, the observation group showed significantly lower intraoperative Ppeak value, incidence of intraoperative adverse reactions, and postoperative agitation score, significantly shorter examination time, and better effects of
amnesia and
anesthesia (P<0.05). There was no significant difference in the degree of intraoperative sedation and postoperative awakening time between the two groups (P>0.05).
CONCLUSIONS:
Dexmedetomidine hydrochloride combined with
midazolam is a safe and effective way to administer
general anesthesia for fiberoptic bronchoscopy in children, which can ensure stable vital signs during examination, reduce intraoperative adverse reactions and postoperative agitation, shorten examination time, and increase amnesic effect.