经皮穴位电刺激对小儿电子耳蜗植入术苏醒期躁动的影响

发布时间：2018-02-20 07:59

本文关键词： 经皮穴位电刺激电子耳蜗植入术控制性降压术后躁动婴幼儿　出处：《中国医科大学学报》2017年04期 　论文类型：期刊论文

【摘要】：目的研究经皮穴位电刺激对先天性聋哑小儿电子耳蜗植入术术后躁动的影响。方法将60例行小儿电子耳蜗植入术患儿(1~4岁)随机均分为2组,实验组(T组)采用经皮穴位电刺激辅以静吸复合麻醉,对照组(C组)不接受穴位刺激。记录麻醉时间、手术时间、围术期血流动力学变化、停药后拔管时间、麻醉恢复室(PACU)停留时间,观察苏醒期躁动及恶心呕吐等情况。结果 2组患儿年龄、性别、体质量、手术时间、PACU停留时间比较,差异无统计学意义。T组在手术开始后30 min、手术结束、拔管即刻及拔管后5 min时平均动脉压及心率均低于同时刻C组,差异有统计学意义(P0.05);T组拔管即刻及拔管后30min内各时点面部疼痛表情量表(FPS-R)和特殊患者疼痛评估量表(FLACC)小儿疼痛评分及小儿麻醉苏醒期烦躁量表(PAED)躁动评分均低于对照组,差异有统计学意义(P0.05);T组拔管时间、麻醉时间及术后恶心呕吐(PONV)的发生率均低于对照组,差异有统计学意义(P0.05)。结论经皮穴位电刺激辅助静吸复合麻醉能明显减轻双耳先天性重度神经性感音性聋小儿术后躁动,术中具有一定的控制性降压作用,缓解苏醒期血流动力学剧烈变化,缩短拔管时间,减少PONV的发生。
[Abstract]:Objective to study the effect of percutaneous acupoint electrical stimulation on restlessness after cochlear implantation in children with congenital deaf-mute. Methods 60 children with cochlear implantation were randomly divided into two groups. The experimental group (group T) was treated with percutaneous acupoint electrical stimulation and combined anesthesia, while the control group (group C) did not receive acupoint stimulation. The time of anesthesia, operation time, hemodynamic changes during perioperative period, and the time of extubation after withdrawal of the drug were recorded. Results Age, sex, body mass, operation time of PACU were compared between the two groups. The mean arterial pressure and heart rate in group T were lower than those in group C at 30 min after operation and 5 min after extubation. The difference was statistically significant (P 0.05). The scores of facial pain and expression scale (FPS-R) and FLACC (Pediatric pain scale) and restlessness scale (PAEDD) were lower in P0.05T group than those in the control group at 30 minutes after extubation and the pain assessment scale FLACC in special patients was lower than that in the control group. The time of extubation, the time of anesthesia and the incidence of postoperative nausea and vomiting in group P 0.05 were lower than those in control group. Conclusion Percutaneous acupoint electrical stimulation combined with intravenous inhalation anesthesia can significantly reduce restlessness in children with congenital severe neurological sensorineural deafness after operation, and has a controlled hypotensive effect during the operation. The hemodynamic changes, the extubation time and the occurrence of PONV were alleviated during the recovery period.
【作者单位】：中国医科大学附属盛京医院麻醉科;
【基金】：国家自然科学基金(81302534)
【分类号】：R726.1

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