三种方法预防小儿门诊手术全身麻醉苏醒期躁动的临床观察  

Clinical observation of preventive effects of three methods on emergence agitation under general anesthesia in pediatric outpatient operation

作　　者：林立荣 

机构地区：[1]广东省佛山市顺德区伦教医院麻醉科,广东佛山528308

出　　处：《吉林医学》2015年第10期1992-1993,共2页Jilin Medical Journal

摘　　要：目的:探讨咪达唑仑、曲马多、舒芬太尼三种药物预防小儿门诊短小手术全身麻醉苏醒期躁动的效果。方法:小儿外科门诊手术800例,随机分4组,全部采用氯胺酮-丙泊酚静脉复合全身麻醉。A组:术毕时不给任何预防性用药,作为对照组;B组:静脉滴注咪达唑仑0.1mg/kg;C组:静脉滴注曲马多1mg/kg;D组:静脉滴注舒芬太尼0.5μg/kg。统计苏醒期轻、中、重躁动例数和总发生率。结果:A组患者躁动发生率高,躁动重度占55.2%;B、C组患者轻、中、重度躁动发生率、总发生率均低于A组(P<0.01);D组重度躁动发生率和总发生率明显低于前三组,差异有统计学意义(P<0.01)。结论:咪达唑仑、曲马多、舒芬太尼三种药物能明显降低小儿门诊短小手术全身麻醉苏醒期躁动发生率,其中舒芬太尼组最低,强效镇痛药物预防效果最为显著。Objective To observe the preventive effects of midazolam,tramadol,sufentanil three kinds drugs on emergence agitation （EA）under general anesthesia in pediatric outpatient short operation. Method 800 cases in pediatric surgery operation were randomly di-vided into 4 groups,all received anesthesia induction with ketamine and propofol. Group A did not give any prophylactic medication at the end of operation,as control group. Group B was intravenously injected with midazolam 0. 1 mg/ kg. Group C was intravenously injected with tramadol 1mg/ kg. Group D was intravenously injected with sufentanil 0. 5 μg/ kg. Light,middle,heavy and total EA incidence rate in recov-ery period were analyzed. Results The EA incidence rate was high in group A,55. 2% of them were heavy EA. Group B,C light,middle, heavy and total EA incidence rate were lower than group A（P ﹤ 0. 01）. Group D heavy and total EA incidence rate were obviously lower than the other three groups（P ﹤ 0. 01）. Conclusion Midazolam,tramadol,sufentanil can significantly reduce EA incidence rate under gen-eral anesthesia in pediatric outpatient short operation,which sufentanil group is the lowest,show preventive effect of potent analgesic is the most significant.

关 键 词：小儿门诊手术 全身麻醉 苏醒期躁动 预防方法 

分 类 号：R726.1[医药卫生—儿科]