不同七氟醚吸入浓度对小儿腺样体手术术后苏醒期烦躁的影响  

Effect of different concentration of sevoflurane on delirium of pediatric anesthetic emergence period after adenoidectomy

作　　者：杨小宇[1] 周雪[1] 周智斌[1] 谢洁[2] 冯霞[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州510080 [2]中山大学附属第一医院手术室,广州510080

出　　处：《岭南现代临床外科》2012年第4期381-383,共3页Lingnan Modern Clinics in Surgery

基　　金：国家自然科学基金(31140050);2011年广东省科技计划国际合作项目(2011B050400024)

摘　　要：目的对比观察吸入不同浓度七氟烷对小儿腺样体手术术后烦躁的影响。方法 38例ASAⅠ级接受腺样体手术的学龄前儿童随机分为七氟烷维持高浓度组(H组)和七氟烷维持低浓度组(L组)。两组均用七氟烷、芬太尼2μg/kg、顺阿曲库胺0.2mg/kg诱导。H组患儿呼出七氟烷浓度为(2.7%～3.0%),术中相维持BIS于40～60;L组将患儿呼出七氟烷的浓度降低至维持于(1.3%～1.8%),不按照BIS值的指导。两组均根据术中生命体征调节瑞芬太尼并记录其用量。在围拔管期,记录两组拔管所需时间;记录拔管后Watcha评分及PAED评分烦躁评分。结果两组患者术后拔管时间差异有统计学意义(P<0.05);拔管后运用两种烦躁评分方法,两者差异均无统计学意义(P>0.05)。结论七氟烷浓度与腺样体手术术后烦躁发生率无明确相关性,但运用低浓度七氟烷可减少拔管所需时间。Objective To investigate the effect of different concentration of sevoflurane on pediatric anesthesia emergence delirium after adenoidectomy. Methods Thirty-eight ASA I children aged 3-8 undergoing adenoidectomy were enrolled and randomized into group H or L. All patients were induced with sevoflurane, fentanyl 2 μg/kg and cisatracurium 0.2 μg/kg. The concentration of sevoflurane in H group was maintained at 2.7%-3.0% according to BIS monitor, while in L group the concentration was maintained at 1.3%-1.8% regardless of BIS. Dosage of remifentanil was reset according to patients＇ vital sign. Around the extubation period, the time of extubation was recorded. After extubation, emergence of delirium were assessed with the scores of Watcha and PAED scale. Results At the time of extubation, there was difference between the two groups in the time of extubation. But there were no differences in the incidence of emergence delirium between two groups. Conclusion The concentration of sevoflurane has no relationship with the incidence of emergence delirium following adenoidectomy, but the low concentration of sevoflruane can shorten the time of extubation.

关 键 词：七氟烷 腺样体手术 儿童 苏醒期烦躁 

分 类 号：R614[医药卫生—麻醉学]