摘要
目的比较丙泊酚与七氟烷2种不同麻醉维持方式对小儿腺扁桃体切除术苏醒期躁动(EA)的影响。方法纳入腺扁桃体切除手术的患儿68例,分为静脉维持组(n=33)和吸入维持组(n=35)。2组患儿以丙泊酚3 mg/kg、舒芬太尼0.5μg/kg、顺苯磺酸阿曲库铵0.1 mg/kg或罗库溴铵0.5 mg/kg依次静脉注射进行麻醉诱导,气管插管机械通气。静脉维持组患儿采用丙泊酚4~10 mg/(kg·h^(-1))持续泵注,吸入维持组使用2%~3%七氟烷吸入,2组患儿均联合瑞芬太尼0.3μg/(kg·min^(-1))维持麻醉至手术结束停药。记录2组患儿拔管后即刻(T_(0))、入麻醉恢复室(PACU)0 min(T_(1))、10 min(T_(2))、20 min(T_(3))、30 min(T4)的躁动评分,FLACC疼痛评分、Ramsay镇静评分、家属满意度以及苏醒期不良反应的发生情况。结果静脉维持组患儿T_(0)—T_(1)时间点躁动发生5例(15.15%),T_(2)—T4时间点无躁动发生;吸入维持组患儿T_(0)—T_(1)时间点躁动发生3例(8.57%),T_(2)—T4时间点躁动发生1例(2.86%)。2组患儿FLACC疼痛评分比较差异无统计学意义(P>0.05)。吸入维持组患儿的Ramsay镇静评分及家属满意度均高于静脉维持组(P<0.05)。结论与丙泊酚全麻维持比较,七氟烷全麻维持不增加小儿腺扁桃体手术苏醒期躁动发生率,PACU的镇静程度较高,家属满意度高。
Objective To compare the effects of propofol and sevoflurane on emergence agitation during the recovery period of pediatric tonsillectomy.Methods A total of 68 children undergoing adenotonsillectomy were randomly divided into the intravenous maintenance group(n=33)and the inhalation maintenance group(n=35).The children in the two groups were all induced to anesthesia by intravenous injection of propofol 3mg/kg,sufentanil 0.5μg/kg,suatracurium 0.1 mg/kg or rocuronium 0.5 mg/kg,followed by mechanical ventilation via tracheal intubation.The intravenous maintenance group received continuous infusion of propofol at 4~10 mg/(kg·h^(-1)).The inhalation maintenance group received inhalation of 2%~3%sevoflurane.Both groups received remifentanil 0.3μg/(kg·min^(-1))to maintain anesthesia until the end of surgery.The emergence agitation score,FLACC pain score,Ramsay sedation score,family satisfaction and the incidence of adverse reactions during the recovery period immediately after extubation(T_(0))and at 0 min(T_(1)),10 min(T_(2)),20 min(T_(3)),30 min(T 4)after admission to the postanesthesia care unit(PACU)were recorded.Results There were 5 cases(15.15%)of agitation during the time points T_(0)to T_(1)and no cases of agitation during the time points T_(2)to T 4 in the intravenous maintenance group.There were 3 cases(8.57%)of agitation during the time points T_(0)to T_(1)and 1 case(2.86%)of agitation during the time points T_(2)to T 4 in the inhalation maintenance group(P>0.05).The PACU sedation score and family satisfaction of patients in the inhalation maintenance group were higher than those in the intravenous maintenance group(P<0.05).Conclusion Compared with propofol maintenance under general anesthesia,sevoflurane general anesthesia maintenance does not increase the incidence of emergence agitation during the recovery period of pediatric tonsillectomy,PACU has a higher degree of sedation and family satisfaction.
作者
包佳敏
韦银娟
李宁康
刘昕
顾洋
叶青山
BAO Jiamin;WEI Yinjuan;LI Ningkang;LIU Xin;GU Yang;YE Qingshan(Ningxia Medical University,Yinchuan 750004,China;Department of Anesthesiology,the People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)
出处
《宁夏医学杂志》
CAS
2024年第10期845-848,共4页
Ningxia Medical Journal
关键词
丙泊酚
七氟烷
麻醉维持
小儿腺扁桃体
苏醒期躁动
Propofol
Sevoflurane
Maintenance of anaesthesia
Pediatric tonsillectomy
Emergence agitation
