咪达唑仑对术后小儿苏醒期躁动及苏醒时间的影响被引量：3

The Effect of Midazolam on Prevention of Emergence Agitation and Emergence Time in Children

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摘要目的：对比研究0.02 mg/kg和0.05 mg/kg咪达唑仑对小儿术后苏醒期躁动及苏醒时间的影响。方法择期行扁桃体和/或腺样体切除术患儿45例，年龄为3～8岁，ASA分级为Ⅰ～Ⅱ级，随机分为3组：咪达唑仑1组（M1组，n=15），咪达唑仑2组（M2组，n=15），对照组（C组，n=15），3组患儿均经芬太尼2μg/kg，依托咪酯0.3 mg/kg，顺式阿曲库铵0.1 mg/kg麻醉诱导，气管插管后吸入七氟醚维持麻醉。手术结束前M1组静脉推注咪达唑仑0.02 mg/kg，M2组静脉推注咪达唑仑0.05 mg/kg，C组静脉推注生理盐水，记录患儿①术前患儿的基础情绪（平静/哭闹）；②苏醒时间（从七氟醚停止开始至拔管的时间）；③术后不良反应包括恶心呕吐，喉痉挛，低氧血症等；④评估苏醒期躁动情况（The Pediatric Anesthesia Emergence Delirium Scale, PAED）；⑤疼痛强度评分，Wong-bank面部表情量表法（faces pain scale, FPS）。结果与M2组比较，M1组及C组的苏醒时间差异有统计学意义（P＜0.05）；与C组比较，M1组苏醒时间差异没有统计学意义（P＞0.05）；与M1组比较，M2组术后PAED躁动评分差异无统计学意义（P＞0.05）；与C组比较，M1组及M2组术后PAED躁动评分差异有统计学意义（P＜0.05）。结论手术结束前静脉内给以0.02 mg/kg咪达唑仑可能可以降低扁桃体和/或腺样体切除术七氟醚麻醉后苏醒期躁动的发生率，同时不影响苏醒时间。 Objective To compare the effects of 0.02 mg/kg and 0.05 mg/kg midazolam on prevention of emergence agitation and emergence time in children. Methods Forty-five children undergoing elective tonsillectomy and/or adenoidectomy were randomly divided into three groups （group M1, group M2 and group C） with fifteen cases each. Anesthesia was induced with fentanyl （2μg/kg）, etomidate （0.3 mg/kg）, cisatracurium （0.1 mg/kg）. After tracheal intubation sevoflurane was used for the maintenance of anesthesia. 0.02 mg/kg of midazolam, 0.05 mg/kg of midazolam, or saline was given independently before the end of surgery. Preoperative anxiety, emergence time, postoperative adverse events were recorded, emergence agitation was valuated by the Pediatric Anesthesia Emergence Delirium Scale （PAED）, pain was valuated by faces pain scale （FPS）. Results The incidence of emergence agitation was lower in patients given 0.02 mg/kg of midazolam and patients given 0.05 mg/kg of midazolam compared with that in patients given saline. The emergence time was longer in patients given 0.05 mg/kg of midazolam compared with that in patients given 0.02 mg/kg of midazolam or saline. Conclusion Intravenous administration of 0.02 mg/kg of midazolam just before the end of surgery may reduce emergence agitation without delaying the emergence time in children having tonsillectomy and/or adenoidectomy surgery with sevoflurane anesthesia.

作者郑小艳冯昌栋胡晓清

机构地区苏州大学附属第一医院麻醉科苏州大学附属第一医院耳鼻咽喉科

出处《中国血液流变学杂志》 CAS 2014年第2期257-259,271,共4页 Chinese Journal of Hemorheology

关键词七氟醚苏醒期躁动咪达唑仑苏醒时间 sevoflurane emergence agitation midazolam emergence time

分类号 R614 [医药卫生—麻醉学]

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