地佐辛预防小儿全身麻醉苏醒期躁动的临床研究

发布时间：2018-08-12 19:26

【摘要】：目的评价地佐辛对小儿七氟烷复合麻醉下行唇腭裂修复术后苏醒期躁动的预防作用。方法以海南省人民医院择期行唇腭裂修复手术患儿60例为研究对象,随机分为研究组(n=30)和对照组(n=30)。手术结束前15 min研究组患儿静脉注射地佐辛0.10 mg/kg,对照组注射等容量生理盐水。记录手术时间,拔除气管导管时间,入麻醉监护治疗室(PACU)时改良Aldrete评分,PACU滞留时间;同时记录躁动评分(PAED)、改良东安大略儿童医院疼痛评分(m-CHEOPS)、苏醒期躁动发生情况以及术毕6 h内不良反应的发生情况。同时记录插管时(T_0)、拔管时(T_1)、拔管后5 min(T_2)时患儿生命体征。结果两组患儿性别、年龄、体重、手术时间及七氟醚吸入浓度等比较,差异无统计学意义(P0.05)。研究组患儿PAED评分及m-CHEOPS评分低于对照组;研究组苏醒期躁动发生率低于对照组(χ~2=13.871,P=0.000)。两组患儿拔管时间、入PACU即刻改良Aldrete评分及PACU滞留时间比较,差异无统计学意义(P0.05)。T_1和T_2时研究组的平均动脉压低于对照组,心率慢于对照组。研究组患儿对地佐辛耐受良好,无不良反应发生。结论手术结束前静脉注射地佐辛可有效抑制小儿唇腭裂修复术全身麻醉后苏醒期躁动的发生,不延长患儿术后苏醒及拔管时间,且无不良反应。
[Abstract]:Objective To evaluate the preventive effect of dezocine on restlessness after cleft lip and palate repair under combined anesthesia with sevoflurane in children.Methods 60 children who underwent selective repair of cleft lip and palate in Hainan Provincial People's Hospital were randomly divided into study group (n=30) and control group (n=30). 0.10 mg/kg of normal saline was injected into the control group. Operation time, tracheal catheter removal time, modified Aldrete score and retention time of PACU were recorded in PACU, and restlessness score (PAED), modified East Ontario Children's Hospital Pain Score (m-CHEOPS), restlessness during recovery and adverse reaction within 6 hours after operation were recorded. Results There was no significant difference in sex, age, weight, operation time and sevoflurane concentration between the two groups (P 0.05). The PAED score and m-CHEOPS score of the study group were lower than those of the control group. The incidence of restlessness was lower than that of the control group (_~2=13.871, P=0.000). There was no significant difference in extubation time, modified Aldrete score and retention time of PACU between the two groups (P 0.05). At T_1 and T_2, the mean arterial pressure of the study group was lower than that of the control group, and the heart rate was slower than that of the control group. Conclusion Intravenous injection of deszocine before operation can effectively inhibit the occurrence of restlessness during recovery period after general anesthesia in children with cleft lip and palate repair without prolonging the time of recovery and extubation and without adverse reactions.
【作者单位】：海南省人民医院麻醉科;
【分类号】：R726.1

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