咪达唑仑滴鼻预防小儿七氟醚麻醉苏醒期躁动疗效观察  

Effect of Midazolam Nasal Drip for Prevention of Emergence Agitation in Children Undergoing Sevoflurane Anesthesia

作　　者：陈华[1] 姚国华[1] 吴桂兰[1] 

机构地区：[1]新疆自治区人民医院北院,新疆乌鲁木齐830054

出　　处：《儿科药学杂志》2015年第3期13-15,共3页Journal of Pediatric Pharmacy

摘　　要：目的：观察鼻内滴入咪达唑仑对预防小儿七氟醚麻醉苏醒期躁动的效果。方法：将50例择期行腹股沟斜疝或睾丸鞘膜积液手术患儿（ASAⅠ-Ⅱ级）随机分为咪达唑仑组（M组）和对照组（N组）。术前30 min,M组患儿鼻腔内滴入咪达唑仑（0.2 mg/kg）,N组滴入生理盐水（1 m L）,两组均给予七氟醚诱导麻醉及维持。记录滴鼻前、滴鼻后30 min、术毕时及苏醒期患儿心率（HR）、平均动脉压（MAP）、血氧饱和度（Sp O2）、呼吸频率（RR）,观察术毕5 min、10 min、30 min、1 h的躁动情况。结果：N组患儿苏醒期HR、MAP、RR均高于滴鼻前、滴鼻后30 min及术毕时（P〈0.05）,M组苏醒期HR与RR均低于N组（P〈0.05）;术后躁动评分显示,M组患儿术毕10 min高于术毕5 min、30 min（P〈0.05）,术毕30 min高于术毕1 h（P〈0.05）;N组患儿除术毕30 min与术毕5 min比较差异无统计学意义外,其余时间点两两比较差异均有统计学意义（P〈0.05）,M组术毕5min、10 min、30 min的躁动评分均低于N组（P〈0.05）。结论：咪达唑仑滴鼻能有效预防小儿七氟醚苏醒期躁动,保持循环系统及呼吸系统的稳定,且方法简单,易被患儿接受。Objective： To observe the effects of midazolam nasal drip for prevention of emergence agitation in children after sevoflurane anesthesia. Methods： Fifty children undergoing inguinal hernia or hydrocele surgery（ ASA Ⅰ - Ⅱ） were chosen and randomly divided into two groups including a control group（ group N） with normal saline（ 1 m L） for nasal drip and a treatment group（ group M） with midazolam（ 0. 2 mg / kg） for nasal drip. All children in the two groups were given sevoflurane induced anesthesia and maintenance. The levels of HR,MAP,Sp O2 and RR were recorded at different time points（ before and after nasal drip,30 min after nasal drip,recovery period and the end of the surgery）. The postoperative agitation at 5 min,10 min,30 min and 1 h after operation were observed.Results： The levels of HR,MAP and RR in group N at recovery period were significantly higher than those before nasal drip,30 min after nasal drip and the end of the surgery（ P〈0. 05）. The levels of HR and RR in group M were significantly lower than group N at recovery period（ P〈0. 05）. The emergence agitation scores of group M at 10 min after operation were significantly higher than 5 min,30 min after operation（ P〈0. 05）,the emergence agitation scores of group M at 30 min after operation were significantly higher than 1hour after operation（ P〈0. 05）. In group N,there were no differences in 5 min and 30 min after operation,there were statistically significant difference in other time points（ P〈0. 05）; The emergence agitation scores of group M were significantly lower than group N in5 min,10 min and 30 min after operation（ P〈0. 05）. Conclusion： Nasal drip can efficiently prevent emergence agitation after sevoflurane anesthesia,and has no affect on anesthesia recovery and hemodynamics.

关 键 词：咪达唑仑 滴鼻 七氟醚 苏醒期 躁动 

分 类 号：R726.1[医药卫生—儿科]