酮咯酸氨丁三醇对儿童患者全身麻醉下扁桃体切除术中芬太尼用量的影响  

Effect of ketorolac tromethamine on intraoperative fentanyl consumption in children undergoing tonsillectomy under general anesthesia

作　　者：张蓬勃[1] 张艺凤 熊虹飞[1] 雷珊[1] 郑娟[1] 吴刚[1] 张珍妮[1] 张粉婷[1] 张会娟[1] 牛晓丽[1] 

机构地区：[1]西安交通大学医学院第二附属医院麻醉科,西安710004 [2]西安北车医院麻醉手术科

出　　处：《山西医科大学学报》2011年第9期766-768,共3页Journal of Shanxi Medical University

基　　金：教育部"新世纪优秀人才支持计划"资助项目(NECT-08-0436)

摘　　要：目的研究酮咯酸氨丁三醇对儿童患者全身麻醉下扁桃体切除术中芬太尼用量的节俭作用。方法择期气管内插管全麻下行扁桃体切除术儿童40例,年龄4-8岁,按住院号奇偶数分为两组:酮咯酸氨丁三醇组和芬太尼组,每组20例。两组患儿的麻醉诱导均为静脉注射咪达唑仑0.1 mg/kg、芬太尼0.005 mg/kg、丙泊酚2 mg/kg、顺式阿曲库胺0.18 mg/kg。酮咯酸氨丁三醇组气管插管完成后立即静脉注射酮咯酸氨丁三醇0.5 mg/kg,芬太尼组不注射酮咯酸氨丁三醇,两组术中均采用静吸复合麻醉。记录入室后平均动脉压(MAP)与心率(HR)、切扁桃体时的MAP与HR、术中出血量、输液量、术毕芬太尼用量及苏醒期躁动情况。结果两组患儿的年龄、性别、体重、入室MAP、HR、术中出血量及术中补液量比较差异无统计学意义(P>0.05);两组患儿切除扁桃体时的MAP差异无统计学意义(P>0.05),但芬太尼组的HR明显高于酮咯酸氨丁三醇组(P<0.05);术毕芬太尼组的芬太尼消耗量高于酮咯酸氨丁三醇组(P<0.05);两组患儿苏醒期躁动评分差异无统计学意义(P>0.05)。结论儿童患者在全身麻醉下行扁桃体切除术中应用酮咯酸氨丁三醇能够明显减少芬太尼的用量且不增加患儿苏醒期的躁动。Objective To investigate the effect of ketorolac tromethamine on intraoperative fentanyl consumption in children undergoing tonsillectomy under general anesthesia.Methods Forty 4-8-year-old children,scheduled for tonsillectomy under general anesthesia,were assigned into two groups according to medical record number：ketorolac tromethamine group and fentanyl group.Combined inhalation and venous anesthesia were used in both groups.Initial mean arterial pressure（MAP） and HR,MAP and HR to resect the tonsil,intraoperative blood loss,fentanyl consumption,volume of fluid infusion,and agitation score during awakening were recorded.Results There was no significant difference in age,gender and body weight of children,initial MAP and HR,MAP to resect the tonsil,intraoperative blood loss,volume of fluid infusion,and the the agitation score during awakening between two groups（P0.05）.HR to resect the tonsil in fentanyl group was significantly higher than that in ketorolac tromethamine group（P0.05）.Intraoperative fentanyl consumption in fentanyl group was significantly higher than that in ketorolac tromethamine group（P0.05）.Conclusion Ketorolac tromethamine can significantly reduce intraoperative fentanyl consumption,but may not increase the agitation during awakening in children undergoing tonsillectomy under general anesthesia.

关 键 词：酮咯酸氨丁三醇 儿童 扁桃体切除术 芬太尼 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]