中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
18期
18-20
,共3页
郑燕国%吴熙文%林宪法%许建军
鄭燕國%吳熙文%林憲法%許建軍
정연국%오희문%림헌법%허건군
二异丙酚%七氟烷%腺样体切除术%麻醉%术后躁动
二異丙酚%七氟烷%腺樣體切除術%痳醉%術後躁動
이이병분%칠불완%선양체절제술%마취%술후조동
Propofol%Sevoflurane%Adenoidectomy%Anesthesia%Postoperative delirium
目的 探讨术终给予单次剂量普鲁泊福对七氟烷麻醉下小儿腺样体切除术后躁动的影响.方法 择期行腺样体切除术患儿60例,根据抽签法随机分为普鲁泊福组和对照组,每组各30例,均采用七氟烷吸入诱导和维持,手术结束后立即停用所有麻醉药,普鲁泊福组静脉注射10%普鲁泊福1 mg/kg,对照组静脉注射等容量0.9%氯化钠.记录两组患儿的手术时间、七氟烷使用时间、麻醉时间、拔管时间、麻醉后恢复室(PACU)停留时间、拔管后30 min内的最高麻醉后躁动(PAED)评分和FLACC疼痛评分.结果 普鲁泊福组PAED评分明显低于对照组[(7.5±3.9)分比(10.9±4.5)分,P＜0.05].普鲁泊福组术后躁动发生率明显低于对照组[20.0%(6/30)比46.7%(14/30),P＜0.05].普鲁泊福组术后拔管时间比对照组要稍微延长[(10.2±1.1)min比(9.1±1.5)min,P＜0.05].而两组麻醉时间、PACU停留时间、FLACC疼痛评分比较差异均无统计学意义(P＞0.05).结论 小儿腺样体切除术麻醉中停用七氟烷后给予单次剂量1 mg/kg的普鲁泊福能明显降低术后躁动的发生,使麻醉更趋平稳,而并不会延长患儿麻醉时间和PACU停留时间,具有一定的临床应用价值.
目的 探討術終給予單次劑量普魯泊福對七氟烷痳醉下小兒腺樣體切除術後躁動的影響.方法 擇期行腺樣體切除術患兒60例,根據抽籤法隨機分為普魯泊福組和對照組,每組各30例,均採用七氟烷吸入誘導和維持,手術結束後立即停用所有痳醉藥,普魯泊福組靜脈註射10%普魯泊福1 mg/kg,對照組靜脈註射等容量0.9%氯化鈉.記錄兩組患兒的手術時間、七氟烷使用時間、痳醉時間、拔管時間、痳醉後恢複室(PACU)停留時間、拔管後30 min內的最高痳醉後躁動(PAED)評分和FLACC疼痛評分.結果 普魯泊福組PAED評分明顯低于對照組[(7.5±3.9)分比(10.9±4.5)分,P＜0.05].普魯泊福組術後躁動髮生率明顯低于對照組[20.0%(6/30)比46.7%(14/30),P＜0.05].普魯泊福組術後拔管時間比對照組要稍微延長[(10.2±1.1)min比(9.1±1.5)min,P＜0.05].而兩組痳醉時間、PACU停留時間、FLACC疼痛評分比較差異均無統計學意義(P＞0.05).結論 小兒腺樣體切除術痳醉中停用七氟烷後給予單次劑量1 mg/kg的普魯泊福能明顯降低術後躁動的髮生,使痳醉更趨平穩,而併不會延長患兒痳醉時間和PACU停留時間,具有一定的臨床應用價值.
목적 탐토술종급여단차제량보로박복대칠불완마취하소인선양체절제술후조동적영향.방법 택기행선양체절제술환인60례,근거추첨법수궤분위보로박복조화대조조,매조각30례,균채용칠불완흡입유도화유지,수술결속후립즉정용소유마취약,보로박복조정맥주사10%보로박복1 mg/kg,대조조정맥주사등용량0.9%록화납.기록량조환인적수술시간、칠불완사용시간、마취시간、발관시간、마취후회복실(PACU)정류시간、발관후30 min내적최고마취후조동(PAED)평분화FLACC동통평분.결과 보로박복조PAED평분명현저우대조조[(7.5±3.9)분비(10.9±4.5)분,P＜0.05].보로박복조술후조동발생솔명현저우대조조[20.0%(6/30)비46.7%(14/30),P＜0.05].보로박복조술후발관시간비대조조요초미연장[(10.2±1.1)min비(9.1±1.5)min,P＜0.05].이량조마취시간、PACU정류시간、FLACC동통평분비교차이균무통계학의의(P＞0.05).결론 소인선양체절제술마취중정용칠불완후급여단차제량1 mg/kg적보로박복능명현강저술후조동적발생,사마취경추평은,이병불회연장환인마취시간화PACU정류시간,구유일정적림상응용개치.
Objective To investigate the effect of a single dose of propofol at the end of surgery on pediatric anesthesia emergence delirium undergoing adenotonsillectomy during sevoflurane anesthesia.Methods Sixty pediatric patients for adenotonsillectomy were randomly divided into propofol group and control group (30 cases in each group), they were undergoing sevoflurane induction and maintaince. The pediatric patients in propofol group were received 1 mg/kg 10% of the propofol intravenous injection at the end of surgery,while the pediatric patients in control group were received the same volume physiological sailine intravenous injection. Duration of surgery, sevoflurane administration, anesthesia time, extubation time were recorded. The highest PAED score after extubation in 30 min were recorded. The time spent in PACU and the FLACC pain score were recorded. Results The PAED score in propofol group was significantly lower than that in control group [(7.5 ± 3.9) scores vs (10.9 ±4.5) scores, P＜0.05]. The incidence rate of postoperative delirium in propofol group was significantly lower than that in control group [20.0% (6/30) vs 46.7% (14/30), P ＜ 0.05 ] . Duration of extubation in propofol group was slightly longer than that in control group[(10.2 ± 1.1 ) min vs (9.1 ± 1 .5 ) min, P ＜ 0.05].There was no statistical significant difference in duration of anesthesia, the time spent in PACU and the FLACC pain score (P ＞0.05).Conclusions The administration a single dose of 1 mg/kg propofol at the end of surgery can effectively reduce pediatric anesthesia emergence delirium undergoing adenotonsillectomy during sevoflurane anesthesia, while can't extend the duration of anesthesia and the time spent in PACU. It has some clinical value.
