CAJ | 학술논문

目的：观察经皮穴位电刺激复合七氟烷麻醉对小儿扁桃体和腺样体摘除术苏醒期躁动的影响。方法将60例择期行扁桃体和腺样体摘除术的患儿（3~6岁）随机分为经皮穴位电刺激组（T组）和对照组（C组），每组各30例。2组患儿麻醉诱导后均行七氟烷吸入麻醉维持，T组同时应用电针刺激合谷和内关穴位直至术毕，C组则不给予电刺激。记录麻醉过程中血流动力学变化、停药后拔管时间、苏醒时间、PACU停留时间，观察术后躁动及恶心呕吐、呼吸抑制等情况。结果比较2组患儿性别、年龄、体质量、麻醉时间、手术时间、拔管时间、苏醒时间、PACU停留时间、术后恶心呕吐、呼吸抑制的发生率，差异无统计学意义（P>0.05）。T组拔管时和入PACU时平均动脉压、心率均低于C组，差异有统计学意义（P<0.05）；T组术后躁动评分低于对照组，差异有统计学意义（P<0.01）。结论经皮穴位电刺激可减少七氟烷全麻下小儿术后躁动的发生率，而不延长拔管时间、苏醒时间、在PACU停留时间，也不增加呼吸抑制的发生率。
목적：관찰경피혈위전자격복합칠불완마취대소인편도체화선양체적제술소성기조동적영향。방법장60례택기행편도체화선양체적제술적환인（3~6세）수궤분위경피혈위전자격조（T조）화대조조（C조），매조각30례。2조환인마취유도후균행칠불완흡입마취유지，T조동시응용전침자격합곡화내관혈위직지술필，C조칙불급여전자격。기록마취과정중혈류동역학변화、정약후발관시간、소성시간、PACU정류시간，관찰술후조동급악심구토、호흡억제등정황。결과비교2조환인성별、년령、체질량、마취시간、수술시간、발관시간、소성시간、PACU정류시간、술후악심구토、호흡억제적발생솔，차이무통계학의의（P>0.05）。T조발관시화입PACU시평균동맥압、심솔균저우C조，차이유통계학의의（P<0.05）；T조술후조동평분저우대조조，차이유통계학의의（P<0.01）。결론경피혈위전자격가감소칠불완전마하소인술후조동적발생솔，이불연장발관시간、소성시간、재PACU정류시간，야불증가호흡억제적발생솔。
Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on emergence agitation in children under?went general anesthesia with sevoflurane. Methods Sixty children aged 3?6 years underwent adenoidectomy and tonsillectomy were selected and randomly divided into two groups:TEAS(group T,n=30)and control(group C,n=30). After venous induction,the general anesthesia was main?tained with sevoflurane. Group T received continuous TEAS at point hegu and neiguan after anesthesia induction till the end of operation. Control group were not given TEAS. The change of the blood flow dynamics in the process of anesthesia,the time of extubation,awaking time and the time in PACU were recorded. The emergence agitation,postoperative nausea and vomitting and respiratory depression were observed. Results There were no significant differences in gender,age,weight,anesthesia time,and operative time between the two groups (P>0.05 ). There was no significant difference in extubation time,awaking time and time in PACU between the two groups(P>0.05). The mean arterial pressure and heart rate in group T were lower than those in group C at the time of extubation and in PACU(P<0.05). The emergence agitation scale in group T was lower than in group C(P<0.01). There was no significant difference in incidence rate of PONV and respiratory depression between two groups. Conclusion TEAS can reduce emergence agitation in children with sevoflurane?induced general anesthesia,but not prolong extubation time,awaking time and time in PACU. In addition,it does not increase the incidence of respiratory depression.