咪达唑仑对门诊学龄前儿童氟烷麻醉后躁动持续时间的影响  

The effect of midazolam on the emergence agitation duration after sevoflurane anesthesia in ambulatory preschool-aged children

作　　者：郁葱[1] 李苏伶[1] 张青[1] 陈思路[1] 罗玉琳[1] 肖水生[2] 

机构地区：[1]重庆医科大学附属口腔医院麻醉科,重庆400015 [2]重庆医科大学附属口腔医院颌面外科,重庆400015

出　　处：《重庆医科大学学报》2010年第12期1867-1869,共3页Journal of Chongqing Medical University

基　　金：重庆市卫生局科研项目(编号:20092155)

摘　　要：目的:观察咪达唑仑对学龄前儿童颌面外科门诊(America society of anesthesia)短小手术七氟烷麻醉后苏醒期躁动(Emergence agitation,EA)的抑制作用,为合理使用药物提供依据。方法:择期口腔颌面部门诊手术患儿40例ASAⅠ级2～5岁,体重15～26 kg,随机分为2组,每组20例,咪达唑仑组(M组)和对照组(C组),两组患儿麻醉方法相同,8%七氟烷吸入1 min后置入喉罩,术中2%～3%七氟烷吸入维持,术中保持自主呼吸,M组术毕前10 min经鼻滴入咪达唑仑0.25 mg/kg,C组滴入生理盐水,两组均于术毕停用七氟烷,待患儿苏醒后采用儿童麻醉EA量表(Pediatric anesthesia emergence delirium scale,PAED)评估并记录躁动期持续时间,苏醒时间和离院时间以及苏醒期不良反应。结果:2组儿童一般资料无统计学意义,M组儿童术后苏醒时间略长于C组(P<0.01),但术后躁动时间明显短于C组(P<0.05),离院时间无差异。结论:咪达唑仑能有效缩短学龄前儿童经七氟烷麻醉门诊口腔颌面部手术术后躁动持续时间,减少不良反应。Objective：To observe the inhibition effect of midazolam on emergency agitation（EA） in preschool-aged children undergoing minor oral-maxillofacial outpatient surgery with sevoflurane anesthesia to provide the basis for the rational use of medicines.Methods：40 ASAⅠchildren,aged from 2 to 5 years old,weighing 15 ～ 26 kg,were divided into 2 groups,midazolam group（group M） and control group（group C）,with 20 children in each group.The anesthetic method for 2 groups was the same,laryngeal mask airway insertion after 8% sevoflurane inhalation for 1 min,2%～ 3% sevoflurane maintenance with spontaneous respiration during operation,Midazolam 0.25 mg/kg was given via nose in group M at 10 min before the operation end;while sodium was given in group C.Both groups were suspended in the completion of surgery sevoflurane.Pediatric anesthesia emergence delirium scale（PAED） was evaluated when children regained consciousness after anesthesia and the agitation of duration,recovery time and discharge time were recorded.Results：There were no significant difference in general data between two groups.The recovery time for group M was slightly longer than that for group C（P0.01）,but postoperative agitation time for group M was significantly shorter than that for group C（P0.05）.There was no difference in discharge time.Conclusion：Midazolam can reduce the emergency agitation duration after outpatient oral-maxillofacial surgery in preschool-aged children undergoing sevoflurane anesthesia without additive adverse drug reactions.

关 键 词：咪达唑仑 七氟烷 苏醒期躁动 儿童 

分 类 号：R654.2[医药卫生—外科学]