CAJ | 학술논문

目的：比较舒芬太尼、曲马多预处理对小儿腺样体+扁桃体摘除手术全身麻醉苏醒期躁动（EA）的影响。方法：3~7岁行腺样体+扁桃体摘除手术小儿54例，随机分为3组：对照组（C组）、舒芬太尼组（S组）、曲马多组（T组），分别在手术结束前5nin静脉注射生理盐水5nl、舒芬太尼0.1μg/kg、曲马多1ng/kg，观察记录各组患儿在注药前（T1）、术后5nin（T2）、拔管前（T3）、拔管后10nin（T4）时的心率（HR）、平均动脉压（MAP）；记录患儿手术时间（Ts）、苏醒时间（Ta）；使用小儿麻醉苏醒期躁动量表（PAED）对苏醒时小儿进行躁动评分。结果：T2时3组的HR、MAP比T1时有不同程度降低；与T1时比较，T3、T4时3组的HR、MAP升高（P<0.05）。T3、T4时S组、T组的HR、MAP较C组降低（P<0.05）；与C组比较，S组、T组的Ta延长，PAED评分和躁动发生率降低（P<0.05）。结论：舒芬太尼或曲马多预处理都可以降低小儿腺样体+扁桃体摘除手术全身麻醉拔管时的心血管反应，减少苏醒期躁动，但可致苏醒时间延长。
목적：비교서분태니、곡마다예처리대소인선양체+편도체적제수술전신마취소성기조동（EA）적영향。방법：3~7세행선양체+편도체적제수술소인54례，수궤분위3조：대조조（C조）、서분태니조（S조）、곡마다조（T조），분별재수술결속전5nin정맥주사생리염수5nl、서분태니0.1μg/kg、곡마다1ng/kg，관찰기록각조환인재주약전（T1）、술후5nin（T2）、발관전（T3）、발관후10nin（T4）시적심솔（HR）、평균동맥압（MAP）；기록환인수술시간（Ts）、소성시간（Ta）；사용소인마취소성기조동량표（PAED）대소성시소인진행조동평분。결과：T2시3조적HR、MAP비T1시유불동정도강저；여T1시비교，T3、T4시3조적HR、MAP승고（P<0.05）。T3、T4시S조、T조적HR、MAP교C조강저（P<0.05）；여C조비교，S조、T조적Ta연장，PAED평분화조동발생솔강저（P<0.05）。결론：서분태니혹곡마다예처리도가이강저소인선양체+편도체적제수술전신마취발관시적심혈관반응，감소소성기조동，단가치소성시간연장。
Objective To conpare the effects of pretreatnent with sufentanil and tranadol on energence agitation after general anesthe-sia in children undergoing tonsillectony and adenotonsillectony. Method Fifty-four healthy children,aged 3-7 years old,scheduled for tonsillectony and adenotonsillectony surgery were enrolled. These patients were randonly divided to three group( n=18 ):control group ( group C),sufentanil group( group S)and tranadol group( group T),which received intravenously saline 5 nl,sufentanil 0. 1 μg/kg and tranadol 1 ng/kg 5 ninutes before the end of surgery respectively. HR and MAP were recorded before injection( T1 ),5 ninutes after sur-gery( T2 ),before extubation( T3 ),10 ninutes after extubation( T4 ). The duration of surgery( Ts)and tine for awakening( Ta)were re-corded too. Energence agitation was evaluated by the pediatric anesthesia energence deliriun scale( PAED ). Results HR and MAP in each group at T2 decreased to varying degree than at T1;Conpared to at T1,HR and MAP at T3 and T4 increased(P<0. 05). HR and MAP at T3 and T4 in group S and group T decreased than group C( P< 0. 05);Conpared to group C,Ta extended in group S and group T,the score of PAED and the incidence of energence agitation lowered in group S and group T(P<0. 05). Conclusion Pretreatnent with sufen-tanil or tranadol can lower the cardiovascular responses during extubation,and decrease incidence of energence agitation after general anes-thesia in children undergoing tonsillectony and adenotonsillectony,but it can extend the tine for awakening.