CAJ | 학술논문

目的：观察对比右美托咪定、帕瑞昔布钠、曲马多分别对小儿扁桃体切除术术后躁动和镇痛的影响及安全性。方法：选择择期拟行扁桃体切除术患儿120例，随机分为右美托咪定组（A组）、帕瑞昔布钠组（B组）、曲马多组（C组）和生理盐水组（D组），每组30例。所有患儿均记录以下指标：不同时间点的 SBP、DBP、HR和SpO2；拔管时间、清醒时间、躁动评分、改良面部表情评分、Ramsay镇静评分及24h内的不良反应。结果：SBP、DBP、HR与插管时比较，D组差异有统计学意义（P＜0．05）；改良面部表情评分D组最高（P＜0．05）；Ramsay镇静评分比较，D组明显低于A、B、C三组（P＜0．05），C组在拔管后10min时明显高于A、B两组（P＜0．05）；躁动评分比较，D组高于A、B、C三组（P＜0．05）。结论：右美托嘧啶、帕瑞昔布钠、曲马多均可安全有效用于小儿扁桃体切除术的镇静、镇痛，但右美托咪定具有更佳的镇静水平和抑制躁动作用。
목적：관찰대비우미탁미정、파서석포납、곡마다분별대소인편도체절제술술후조동화진통적영향급안전성。방법：선택택기의행편도체절제술환인120례，수궤분위우미탁미정조（A조）、파서석포납조（B조）、곡마다조（C조）화생리염수조（D조），매조30례。소유환인균기록이하지표：불동시간점적 SBP、DBP、HR화SpO2；발관시간、청성시간、조동평분、개량면부표정평분、Ramsay진정평분급24h내적불량반응。결과：SBP、DBP、HR여삽관시비교，D조차이유통계학의의（P＜0．05）；개량면부표정평분D조최고（P＜0．05）；Ramsay진정평분비교，D조명현저우A、B、C삼조（P＜0．05），C조재발관후10min시명현고우A、B량조（P＜0．05）；조동평분비교，D조고우A、B、C삼조（P＜0．05）。결론：우미탁밀정、파서석포납、곡마다균가안전유효용우소인편도체절제술적진정、진통，단우미탁미정구유경가적진정수평화억제조동작용。
Objective :To compare the anesthetic effects of Dexmedetomidine ,Parry Celebrex sodium or Tramadol for children during tonsillectomy .Methods :120 children aged 4 to 10 years ,ASA graded ⅠorⅡ ,scheduled for tonsillecto-my under general anesthesia were randomly divided into Dexmedetomidine group(group A ,n=30) ,Parry Celebrex so-dium group (group B ,n=30) ,Tramadol (group C ,n=30) or Normal saline group (D ,n=30) .The changes of SBP , DBP ,HR and SpO2 were recorded at the time point of intubation ,extubation ,1h or 4h after extubation .The extubation time ,palinesthesiav time ,restlessness scores ,improvement of facial expression score ,ramsay sedation score and com-plication during 24h postoperation were recorded .Results:The SBP ,DBP or HR of patients in group D had a significant increase at the time of extubation or 1h post extubation compared with group A ,B or C (P<0 .05) .Compared with group A ,B ,or C ,the patients in group D had a higher improvement of facial expression score after operation ,in parti-cular for 1h post operation (P<0 .05) .The restlessness scores in group D increased significantly compared with group A ,B or C at 10min ,1h or 4h post operation (P<0 .05) .Group D had a higher restlessness scores compared with the other three groups at the time of extubation or 10min ,1h ,4h post extubation (P<0 .05) .Group B had a higher rest-lessness scores compared with group A or C 10min post extubation (P<0 .05) .Conclusion:Dexmedetomidine ,Parry Celebrex sodium or Tramadol is safe and effective for children undergoing tonsillectomy .Notably ,Dexmedetomidine has a great effect on sedation and alleviating restlessness .