患儿被随机分为三组：术前用药组接受2 ug.kg-1右美托咪定滴鼻；术中用药组静脉注射右美托咪定1 ug.kg-1；对照组。主要结果是使用门诊手术住院后行为调查问卷(PHBQ-AS)和优势与困难调查问卷(SDQ)评估术后第3天不良行为的发生率。次要结果包括：术后第14天和28天的不良行为发生率、诱导时焦虑、出现谵妄、疼痛、康复时间和住院时间，以及任何不良反应。
综上所述，右美托咪定并不能减少2 ~ 7岁儿童日间手术后第3天的不良行为发生率。
Lee-Archer PF, von Ungern-Sternberg BS, Reade M, et al. The effect of dexmedetomidine on postoperative behaviour change in children: a randomised controlled trial.[J].Anaesthesia. 2020 Jun 13. doi: 10.1111/anae.15117.
Children may develop changes in their behaviour following general anaesthesia. Some examples of negative behaviour include temper tantrums and nightmares, as well as sleep and eating disorders. The aim of this study was to determine whether dexmedetomidine reduces the incidence of negative behaviour change after anaesthesia for day case surgery in children aged two to seven years.
Children were randomly allocated to one of three groups: a premedication group received 2 mg.kg-1 intranasal dexmedetomidine; an intra-operative group received 1 mg.kg-1 intravenous dexmedetomidine; and a control group. The primary outcome was the incidence of negative behaviour on postoperative day 3 using the Post-Hospitalisation Behaviour Questionnaire for Ambulatory Surgery (PHBQ-AS) and the Strength and Difficulties Questionnaire (SDQ). Secondary outcomes included: the incidence of negative behaviour on postoperative days 14 and 28; anxiety at induction; emergence delirium; pain; length of recovery and hospital stay; and any adverse events.
The data for 247 patients were analysed. Negative behaviour change on postoperative day 3 was similar between all three groups when measured with the PHBQ-AS (47%, 44% and 51% respectively; adjusted p=0.99) and the SDQ (median scores 7.5, 6.0 and 8.0 respectively; adjusted p=0.99). The incidence of negative behaviour in the group who received dexmedetomidine intra-operatively was less at postoperative day 28 (15% compared with 36% in the dexmedetomidine premedication group and 41% in the control group, p<0.001).
We conclude that dexmedetomidine does not reduce the incidence of negative behaviour on postoperative day 3 in two to seven-year olds having day case procedures.
认可我就打赏我~1元 5元 10元 20元 50元 其它