CAJ | 학술논문

目的评价眯达唑仑术前用药预防短小手术患儿七氟醚麻醉恢复期躁动(EA)的效果.方法择期扁桃体联合腺样体切除术患儿120例,性别不限,年龄3～9岁,体重15～35 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为4组(n=30),麻醉前30 min,对照组(C组)口服10％葡萄糖10 ml,不同剂量咪达唑仑组(M1-3组)分别口服0.25、0.50和0.75 mg/kg咪达唑仑与10％葡萄糖混合液10 ml.吸入七氟醚麻醉诱导,静脉输注瑞芬太尼和吸入七氟醚维持麻醉.采用患儿麻醉恢复期躁动量化评分表(PAED)评价患儿EA的发生情况.结果与C组比较,M2组和M3组PAED评分及EA发生率降低(P＜0.05),M1组差异无统计学意义(P＞0.05)；与M1组比较,M2组和M3组PAED评分及EA发生率降低(P＜0.05)；与M2组比较,M3组PAED评分及EA发生率差异无统计学意义(P＞0.05).结论口服咪达唑仑术前用药可预防患儿短小手术七氟醚麻醉恢复期躁动,其适宜剂量为0.50 mg/kg.
목적 평개미체서륜술전용약예방단소수술환인칠불미마취회복기조동(EA)적효과.방법 택기편도체연합선양체절제술환인120례,성별불한,년령3～9세,체중15～35 kg,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법,장기분위4조(n=30),마취전30 min,대조조(C조)구복10％포도당10 ml,불동제량미체서륜조(M1-3조)분별구복0.25、0.50화0.75 mg/kg미체서륜여10％포도당혼합액10 ml.흡입칠불미마취유도,정맥수주서분태니화흡입칠불미유지마취.채용환인마취회복기조동양화평분표(PAED)평개환인EA적발생정황.결과 여C조비교,M2조화M3조PAED평분급EA발생솔강저(P＜0.05),M1조차이무통계학의의(P＞0.05)；여M1조비교,M2조화M3조PAED평분급EA발생솔강저(P＜0.05)；여M2조비교,M3조PAED평분급EA발생솔차이무통계학의의(P＞0.05).결론 구복미체서륜술전용약가예방환인단소수술칠불미마취회복기조동,기괄의제량위0.50 mg/kg.
Objective To evaluate the efficacy of midazolam premedication for prevention of emergence agitation (EA) after sevoflurane anesthesia in children undergoing minor surgery.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ paediatric patients,aged 3-9 yr,weighing 15-35 kg,scheduled for elective tonsillectomy and adenoidectomy,were randomly divided into 4 groups (n =30 each):control group (group C) and midazolam 0.25,0.50 and 0.75 mg/kg groups (groups M1-3).The 10 ml mixture of midazolam 0.25,0.50 and 0.75 mg/kg and 10％ glucose was taken orally at 30 min before anesthesia in M1-3 groups,respectively,while 10 ml of 10％ glucose was taken orally in group C.Anesthesia was induced with inhalation of sevoflurane and maintained with iv infusion of remifentanil and inhalation of sevoflurane.EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Results Compared with group C,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05),and no significant change was found in group M1 (P ＞ 0.05).Compared with group M1,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05).There was no significant difference in the PAED scores and incidence of EA between groups M3 and M2 (P ＞ 0.05).Conclusion Premedication with oral midazolam can prevent EA following sevoflurane anesthesia in children undergoing minor surgery and the optimum dose is 0.50 mg/kg.