地佐辛预防患儿全麻苏醒期躁动的效果  

Preventive effects of dezocine on emergence agitation in children

作　　者：朱卓[1] 姜葳[1] 崔云凤[1] 潘振祥[1] 

机构地区：[1]130041吉林省长春市吉林大学第二医院麻醉科

出　　处：《临床麻醉学杂志》2014年第1期24-26,共3页Journal of Clinical Anesthesiology

摘　　要：目的 评价地佐辛预防患儿全凭静脉麻醉下行扁桃体联合腺样体切除术后苏醒期躁动的效果.方法 择期行扁桃体联合腺样体切除术患儿60例,年龄3～7岁,ASAⅠ或Ⅱ级,随机均分为两组：地佐辛组（D组）和生理盐水组（C组）.静脉注射芬太尼2 μg/kg、丙泊酚2.0 mg/kg、顺阿曲库铵0.15mg/kg快速诱导,气管内插管后行机械通气.麻醉维持：微量泵持续输注丙泊酚9～15μg·kg-1 ·min-1、瑞芬太尼0.05～0.20 μg·kg-1 ·min-1.手术结束前15 min,D组、C组分别静脉注射地佐辛0.1 mg/kg和等容积的生理盐水.记录手术时间、拔除气管导管时间、入麻醉后监测治疗室（PACU）即刻改良Aldrete评分、PACU滞留时间;同时入PACU即刻,10、20、30 min记录躁动评分（PAED）及改良加拿大东安大略儿童医院疼痛评分（m-CHEOPS）及术毕6h内不良反应的发生情况.结果 与C组比较,D组人PACU即刻、10 min PAED评分明显降低（P＜0.05）;入PACU后即刻、10、20、30 min的m-CHEOPS评分明显降低（P＜0.05）;拔除气管导管时间、入PACU即刻改良Aldrete评分及PACU滞留时间差异无统计学意义;术后6h内不良反应发生率差异无统计学意义.结论 手术结束前15 min静脉注射地佐辛0.1 mg/kg对小儿全麻苏醒期躁动有预防作用,不延长术后苏醒及拔除气管导管时间,不增加术后不良反应发生率.Objective To evaluate the preventive effects of dezocine on emergence agitation from total intravenous anesthesia in children undergoing post-adenotonsillectomy.Methods Sixty children,ASA Ⅰ or Ⅱ,aged 3-7 y,were equally randomized into 2 groups：dezocine group （group D） and normal saline group （group C）.Anesthesia was induced with fentanyl 2μg/kg,propofol 2.0 mg/kg and cisatracurium 0.15 mg/kg followed by endotracheal intubation and mechanical ventilation.Anesthesia was maintained with propofol 9-15μg·kg-1 ·min-1 and remifentanil 0.05-0.20 μg·kg-1 ·min-1 through infusion pump.Dezocine 0.1 mg/kg or saline in equal volume was intravenously injected groups D and C,respectively,15 min before the end of surgery.The operation time,extubation time,modified Aldrete score immediately after admitted to postanesthesia care unit （PACU） and residence time at PACU were recorded.Pediatric anesthesia emergence delirium （PAED） and modified children＇s hospital of eastern ontario pain scale （m-CHEOPS） were recorded every 10 min in the first 30 min in of PACU,and the adverse reaction within 6 h after surgery was recorded.Results Compared with group C,PAED scores at immediately,10 min and m-CHEOPS scores at every time point after admitted to PACU were decreased in group D （P〈0.05）.There was no significant difference in extubation time,modified Aldrete score immediately after admitted to PACU and residence time at PACU between the two groups.There was no significant difference in the adverse reaction within 6 h after surgery between the two groups.Conclusion Dezocine 0.1 mg/kg given intravenously 15 min before the end of surgery is effective on the prevention of emergence agitation without delayed recovery and extubation time and increased adverse reaction in children.

关 键 词：地佐辛 小儿 躁动 扁桃体联合腺样体切除术 

分 类 号：R726.1[医药卫生—儿科]