术毕前15min静注舒芬太尼对腭裂整复术患儿术后苏醒期躁动的预防效果

发布时间：2019-05-07 10:19

【摘要】：目的观察术毕前15 min静注舒芬太尼对腭裂整复术患儿术后苏醒期躁动的预防效果。方法 80例择期全麻下行腭裂整复术腭裂患儿随机分为A、B、C、D组各20例,各组均采用瑞芬太尼、丙泊酚全凭静脉麻醉,术毕前15 min分别静注舒芬太尼(A组0.10μg/kg,B组0.15μg/kg,C组0.20μg/kg),D组静注生理盐水2 m L。记录各组呼吸恢复时间、拔管时间、苏醒时间(停药至呼之睁眼的时间)、离麻醉后监测治疗室(PACU)时间,观察拔管时(T1)、苏醒时(T2)、离PACU时(T3)的平均动脉压(MAP)、心率(HR)及并发症发生情况,使用国际通用的小儿苏醒期躁动(PAED)评分评价苏醒期躁动情况。结果与A组比较,B、C组PAED评分减少(P均0.05);与D组比较,A、B、C组PAED评分减少(P均0.05)。与C组比较,A、B、D组拔管、苏醒、离PACU时间短(P均0.05)。与A组比较,B、C组T2、T3时点MAP、HR水平降低(P均0.05);与D组比较,A、B、C组T2、T3时点MAP、HR水平降低(P均0.05)。A组发生低氧血症2例、上呼吸道梗阻4例、恶心呕吐0例、渗血0例,B组分别为0、1、0、2例,C组分别为0、0、0、2例,D组分别为1、1、1、6例,各组比较,P均0.05。结论对于小儿腭裂手术,术毕前15 min静注0.15μg/kg舒芬太尼,可在不延长苏醒及离PACU时间的同时有效预防苏醒期躁动,保持苏醒期心血管系统稳定。
[Abstract]:Objective to observe the preventive effect of sufentanil 15 min before operation on restlessness in children with cleft palate surgery. Methods 80 children with cleft palate underwent elective general anesthesia were randomly divided into three groups: group A, B, C, D with remifentanil and propofol by intravenous anesthesia. Sufentanil was injected intravenously 15 min before the end of operation (group A 0.10 渭 g / kg,). Group B, 0.15 渭 g / kg,C, 0.20 渭 g / kg), D, was intravenously injected with normal saline 2 ml 路L ~ (- 1). The respiratory recovery time, extubation time, recovery time (time from drug withdrawal to extubation), (PACU) time in treatment room after anesthesia were recorded, extubation time (T1), recovery time (T2) were observed, and the time of extubation (T1) and recovery time (T2) were observed. The incidence of heart rate (HR) and complications in the mean arterial pressure (MAP),) of PACU was evaluated by using the internationally available (PAED) score of infantile restlessness at recovery stage. Results compared with group A, the scores of PAED in group B and C were lower than those in group D, and the scores of PAED in group A, B and C were lower than those in group D (all P 0.05). Compared with C group, A, B, D group extubation, awakening, the time from PACU was shorter than that of C group (all P 0.05). Compared with group A, the level of MAP,HR in group B and group C was lower than that in group B and group C at T 2 and T 3 (all P 0.05). Compared with group D, the levels of MAP,HR in group A, B, C at T _ 2 and T _ 3 were lower than those in group D (P 0.05). A, n = 2), including hypoxemia (n = 2), upper respiratory obstruction (n = 4), nausea and vomiting (n = 0), bleeding (n = 0), group B (n = 0), and group B (n = 2). C group was 0, 0, 0, 2 cases, D group was 1, 1, 1, 6 cases, all of them were 0.05. Conclusion intravenous injection of 0.15 渭 g / kg sufentanil at 15 min before the end of the operation in children with cleft palate can effectively prevent restlessness and maintain the stability of cardiovascular system in the recovery period without prolonging the recovery time and leaving PACU.
【作者单位】：广西医科大学附属口腔医院;
【基金】：广西科学研究与技术开发计划项目(桂科攻1355005-7-2) 广西医疗卫生事宜技术研究与开发项目(S201411-02)
【分类号】：R726.1

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