地佐辛对小儿丙泊酚-瑞芬太尼静脉全麻苏醒期躁动的影响

发布时间：2019-02-23 20:08

【摘要】：目的探讨地佐辛对小儿丙泊酚-瑞芬太尼全凭静脉麻醉苏醒期躁动的影响。方法选择择期2~6岁腹腔镜下腹股沟斜疝修补术患儿100例(ASA I级),随机分为两组:A组(n=50)以丙泊酚-瑞芬太尼-维库溴铵顺序诱导经口明视气管插管,采用丙泊酚-瑞芬太尼全凭静脉维持麻醉,手术结束前10 min静脉滴注地佐辛0.1 mg/kg;C组(n=50)麻醉诱导与维持同A组,但手术结束前10 min静脉滴注生理盐水2 m L,持续监测患儿心电图、心率(HR)、平均动脉压(MAP)及脉搏血氧饱和度(Sp O2)、呼气末二氧化碳分压,分别记录拔管时(T1)、拔管后5 min(T2)及拔管后15 min(T3)各时间点HR、MAP、Sp O2变化值,记录各组患儿的拔管时间、清醒时间及拔管前后各时间点躁动评分及意识状态(OAA/S)评分,术毕6 h内不良反应的发生情况。结果两组术中HR、MAP、Sp O2较为稳定(P0.05),而全麻苏醒期A组T2、T3时间点MAP,HR明显低于C组(P0.05),C组T1、T2、T3时间点躁动评分分别为(2.73±0.52)分、(2.33±0.36)分、(2.05±0.54)分,明显高于A组的(2.35±0.34)分、(1.21±0.44)分、(0.65±0.08)分,A组与C组苏醒期躁动发生率分别为22%与80%(P0.05);两组清醒时间及拔管时间差异无统计学意义;术后6 h内不良反应发生率差异无统计学意义(P0.05)。结论以丙泊酚-瑞芬太尼-维库溴铵顺序诱导经口明视气管插管,采用丙泊酚-瑞芬太尼全凭静脉维持麻醉,手术结束前10 min静脉滴注地佐辛(0.1 mg/kg)能有效的预防小儿丙泊酚-瑞芬太尼全麻苏醒期躁动的发生。
[Abstract]:Objective to investigate the effect of dizosin on restlessness during total intravenous anesthesia in children with propofol-remifentanil. Methods A total of 100 children (ASA I grade) undergoing laparoscopic inguinal herniorrhaphy were randomly divided into two groups: group A (n = 50) was treated with propofol, remifentanil and vecuronium to induce the intubation of tracheal intubation via open vision in the order of propofol, remifentanil and vecuronium. Propofol-remifentanil was administered intravenously to maintain anesthesia 10 min before operation. Dizosin 0.1 mg/kg; was injected intravenously 10 min before the end of the operation. Anesthesia induction and maintenance in group C (NN50) was similar to that in group A, but normal saline was injected intravenously 10 min before the end of operation. The electrocardiogram (ECG), mean arterial pressure (MAP) of heart rate (HR),) and pulse oxygen saturation (Sp O 2) were continuously monitored. End expiratory partial pressure of carbon dioxide was recorded during extubation (T1), 5 min (T2) after extubation and 15 min (T3) after extubation. The time of extubation was recorded. Waking time, restlessness score and consciousness state (OAA/S) score before and after extubation, and the occurrence of adverse reactions within 6 hours after operation. Results during operation, HR,MAP,Sp O 2 was stable in both groups (P0.05), while MAP,HR at T _ 2 T _ 3 time point in group A was significantly lower than that in C group (P 0.05). The restlessness score of T _ 2 T _ 3 in group A was (2.73 卤0.52) points, respectively, in group T _ (1) and T _ (2) T _ (3) in group A (P < 0.05). The scores of (2.33 卤0.36), (2.05 卤0.54) were significantly higher than those of group A (2.35 卤0.34), (1.21 卤0.44), (0.65 卤0.08), respectively. The incidence of restlessness in group A and C was 22% and 80% respectively (P0.05). There was no significant difference in waking time and extubation time between the two groups, and there was no significant difference in the incidence of adverse reactions within 6 hours after operation (P0.05). Conclusion Propofol-remifentanil-vecuronium was used to induce open vision tracheal intubation, and propofol-remifentanil was used to maintain anesthesia. Intravenous infusion of dizosin (0. 1 mg/kg) 10 min before the end of operation could effectively prevent restlessness during general anesthesia in children with propofol-remifentanil.
【作者单位】：广东省深圳市儿童医院麻醉科;广东省深圳市宝安区妇幼保健院麻醉科;
【分类号】：R726.1

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