地佐辛对小儿七氟烷复合麻醉苏醒期躁动及血流动力学的影响  

Effects of dezocine on emergence agitation and hemodynamics during recovery from sevoflurane-based anesthesia in children

作　　者：卢增停[1] 杨纲华[1] 何绮桃[1] 曾丽蓉[1] 林霭婷[1] 

机构地区：[1]南方医科大学附属小榄医院麻醉科,广东中山528415

出　　处：《中国新药与临床杂志》2014年第4期260-262,共3页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的评价地佐辛对小儿七氟烷复合麻醉苏醒期躁动及血流动力学的影响。方法择期行下腹部手术患儿60例,随机分为两组,每组30例。两组麻醉诱导方法相同,术中吸入2%～3%七氟烷,持续静脉输注瑞芬太尼0.1～0.5μg·kg-1·min-1维持麻醉。手术结束前20 min,地佐辛组和对照组分别静脉注射地佐辛0.1 mg·kg-1和等容量氯化钠注射液。记录手术时间、清醒时间;记录患儿清醒时(T1),拔喉罩后1 min(T2)、5 min(T3)、10 min(T4)各时间点的心率(HR)和平均动脉压(MAP);记录躁动和不良反应的发生情况。结果两组患儿手术时间和清醒时间均无显著差异(P>0.05)。与对照组比较,T1～T4时地佐辛组MAP降低,HR减慢(均P<0.05)。地佐辛组躁动发生率为17%(5/30),低于对照组[60%(18/30)],躁动持续时间大于15 min的患儿少于对照组(0例vs.15例),差异均有显著意义(P<0.05)。两组不良反应发生率无显著差异(P>0.05)。结论地佐辛0.1 mg·kg-1可有效预防小儿七氟烷复合麻醉苏醒期躁动的发生,减轻患儿血流动力学变化且不增加不良反应。AIM To evaluate the effects of dezocine on emergence agitation （EA） and hemodynamics during recovery from sevoflurane-based anesthesia in children. METHODS Sixty patients scheduling for elective lower abdominal operation were randomly divided into two groups, thirty patients in each group. Anesthesia induction in two groups was the same and the general anesthesia was maintained with inhalation of 2% - 3% sevoflurane and infusion of remifentanil at 0.1 - 0.5 μg·kg^-1·min^-1 during operation. Dezocine 0.1 mg·kg^-1 （the dezocine group） and the equal volume of sodium chloride injection （the control group） were injected respectively at 20 min before the end of operation. The operation time and the time of awakening were recorded. Heart rate （HR） and mean arterial pressure （MAP） were recorded at child awaken （T1） and 1 rain （T2）,5 min （T3） and 10 min （T4） after extubation. The occurrence of EA and adverse reactions were recorded. RESULTS There were no significant differences in operation time and the time of awakening between the two groups （P 〉 0.05）. Compared with the control group, MAP was lower and HR was slowed down in the dezocine group at T1- T4 （P 〈 0.05）. The rate of EA in the dezocine group was significantly lower than that in the control group （17% （5/30） vs. 60% （18/30）, P 〈 0.05）. The number of patients with EA duration more than 15 min in the dezocine group was less than that in the control group （0 vs.15, P 〈 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P 〉 0.05） . CONCLUSION Dezocine 0.1 mg-kg^-1 can effectively prevent the occurrence of EA during recovery from sevoflurane-based anesthesia in children, and reduce the hemodynamic changes of children without increasing the adverse reactions.

关 键 词：地佐辛 七氟烷 儿童 麻醉恢复期 躁动 血流动力学 

分 类 号：R971[医药卫生—药品] R726.1[医药卫生—药学]