布托啡诺治疗不同年龄小儿全麻后苏醒期躁动的效果及安全性研究  

Efficacy and Safety of Butorphanol on Emergence Agitation after Sevoflurane General Anesthesia in Pediatrics with Different Ages

作　　者：戴平 罗宏[2] 黄燕丽 路牧 蔡栋江 郦正阳 李军[2] 

机构地区：[1]浙江省诸暨市人民医院麻醉科,311800 [2]温州医学院附属第二医院麻醉科,325027

出　　处：《医学研究杂志》2012年第3期83-86,共4页Journal of Medical Research

摘　　要：目的观察布托啡诺用于不同年龄小儿七氟烷全麻后苏醒期躁动的治疗效果及安全性。方法选择ASAⅠ或Ⅱ级七氟烷全麻患儿120例,根据年龄分为1～2岁、3～5岁及6～12岁,每组各随机分为两组:布托啡诺组(B1组、B2组、B3组,n=20)和对照组(C1组、C2组和C3组,n=20)。患儿进入麻醉后恢复室(PACU)后B组静注布托啡诺30μg/kg,C组静注等容积生理盐水,记录给药前(T0)、给药后5min(T1)、10min(T2)、15min(T3)、30min(T4)及出PACU(T5)时点血流动力学、呼吸变化,记录躁动程度及发生率、苏醒时间、PACU停留时间、术后4h及8h Ramsay镇静评分,观察不良反应发生情况。结果与T0相比,B组患儿T2～T5时点的SBP、DBP显著下降(P<0.05),T1-4时点HR显著下降(P<0.05);与C组相比,B组患儿T1-5时点SBP显著下降(P<0.05)。与C组相比,B组术后躁动发生率显著下降,B2组、B3组术后重度躁动发生率显著减少(P<0.05);但B1组、B2组苏醒时间显著延长(P<0.01),且B1组PACU停留时间显著延长(P<0.05);B组患儿术后4h镇静评分较C组显著增加(P<0.05),且术后嗜睡发生率较C组明显增加(P<0.05)。结论 30μg/kg布托啡诺能安全、有效治疗小儿全麻苏醒期躁动,不延长6～12岁患儿苏醒时间和3～12岁患儿PACU停留时间,但增加术后嗜睡的发生。Objective To investigate the efficacy and safety of butorphanol on emergence agitation after sevoflurane general anesthesia in pediatrics with different ages. Methods 120 pediatrics with ASA status Ⅰ or Ⅱ after sevoflurane general anesthesia were divided into three age groups with 40 patients in each：1 -2 years, 3 -5 years and 6 - 12 years,and each group was randomly divided into two sub - groups：butorphanol group（ Group B1, Group B2, Group B3, n = 20） and control group（ Group C1, Group C2, Group C3, n = 20）. Pediatrics in Group B were intravenous injected butorphanol 30μg/kg after enter PACU, and in Group C were intravenous injected normal saline solution. SBP, DBP, H R and RR were recorded before （ TO ） and at 5 rain （ T1 ） , 10min （ T2 ） , 15 min （ T3 ） , 30min （ T4 ） after injection and leave PACU （T5）. The incidence and the degree of emergence agitation, recovery time, the time of staying in PACU, 4h or 8h Ramsay scores and side effect were recorded. Results SBP,DBP in Group B at T2 - T5 decreased significantly compared with those at T0（P 〈 0. 05）. HR in Group B at T1 - T4 deereased significantly compared with those at TO （P 〈 0. 05 ）. SBP in Group B at T1 - T5 decreased significantly compared with Group C（P 〈 0. 05）. The incidence and the degree of emergence agitation in Group B was significantly lower than in group C（ P 〈 0.05 ）. The recovery time in Group Bland B2 was much longer than that in Group C1 and C2（ P 〈 0.05 ）. The time of staying in PACU in Group B1 was much longer than that in Group C1 （P 〈 0.05）. The 4h Ramsay scores in Group B was significantly higher than in Group C （ P 〈 0.05 ）. The lethargy in Group B was much more than in Group C （ P 〈 0.05 ）. Conclusion 30μg/kg butor- phanol intravenous injected could reduce emergence agitation after sevoflurane general anesthesia in pediatrics and was safe and feasible. The recovery time in 6 - 12 years children and the time of staying in PACU in 3 - 12 years chil

关 键 词：布托啡诺 小儿 全麻 苏醒期躁动 

分 类 号：R619[医药卫生—外科学]