术毕前15min静注舒芬太尼对腭裂整复术患儿术后苏醒期躁动的预防效果  

Preventive efficiency of intravenous injection of sufentanil 15 minutes before completion of surgery on emergence agitation in children undergoing cleft palate repair

作　　者：龙翔[1] 施小彤[1] 沈浩林[1] 王维[1] 林威威[1] 

机构地区：[1]广西医科大学附属口腔医院,南宁530000

出　　处：《山东医药》2015年第35期22-24,共3页Shandong Medical Journal

基　　金：广西科学研究与技术开发计划项目(桂科攻1355005-7-2);广西医疗卫生事宜技术研究与开发项目(S201411-02)

摘　　要：目的观察术毕前15 min静注舒芬太尼对腭裂整复术患儿术后苏醒期躁动的预防效果。方法 80例择期全麻下行腭裂整复术腭裂患儿随机分为A、B、C、D组各20例,各组均采用瑞芬太尼、丙泊酚全凭静脉麻醉,术毕前15 min分别静注舒芬太尼(A组0.10μg/kg,B组0.15μg/kg,C组0.20μg/kg),D组静注生理盐水2 m L。记录各组呼吸恢复时间、拔管时间、苏醒时间(停药至呼之睁眼的时间)、离麻醉后监测治疗室(PACU)时间,观察拔管时(T1)、苏醒时(T2)、离PACU时(T3)的平均动脉压(MAP)、心率(HR)及并发症发生情况,使用国际通用的小儿苏醒期躁动(PAED)评分评价苏醒期躁动情况。结果与A组比较,B、C组PAED评分减少(P均<0.05);与D组比较,A、B、C组PAED评分减少(P均<0.05)。与C组比较,A、B、D组拔管、苏醒、离PACU时间短(P均<0.05)。与A组比较,B、C组T2、T3时点MAP、HR水平降低(P均<0.05);与D组比较,A、B、C组T2、T3时点MAP、HR水平降低(P均<0.05)。A组发生低氧血症2例、上呼吸道梗阻4例、恶心呕吐0例、渗血0例,B组分别为0、1、0、2例,C组分别为0、0、0、2例,D组分别为1、1、1、6例,各组比较,P均>0.05。结论对于小儿腭裂手术,术毕前15 min静注0.15μg/kg舒芬太尼,可在不延长苏醒及离PACU时间的同时有效预防苏醒期躁动,保持苏醒期心血管系统稳定。Objective To observe the preventive efficiency of intravenous injection of sufentanil 15 minutes before com-pletion of surgery on emergence agitation in children undergoing cleft palate repair.Methods Eighty children undergoing cleft palate repair were randomly divided into four groups, 20 cases in each group：sufentanil groups （ groups A, B and C） and the control group （ group D） .After venous induction, the general anesthesia was maintained with remifentanil and propo-fol.About 15 minutes before completion of surgery, groups A, B and C were respectively administrated with intravenously sufentanil at dose of 0.10μg/kɡ, 0.15μg/kɡand 0.20μg/kɡ.Group D was intravenously injected with normal saline.Pe-diatric anesthesia emergence delirium （ PAED） scale was used to evaluate the emergence agitation, and the respiration recov-ery time, time of tracheal extubation, recovery time, time of leaving postanesthesia care unit （ PACU） were recorded.Mean-while, mean arterial pressure （ MAP） and heart rate （ HR） were recorded at time points of tracheal extubation （ T1 ） , being awake （ T2 ） and leaving PACU （ T3 ） , respectively.Results Compared with group A, PAED scores in the groups B and D were decreased （all P〈0.05）;compared with group D, PAED scores in the groups A, B and C were decreased （all P〈0.05）.Compared with group C, the time of tracheal extubation, recovery time and time of leaving PACU was significantly shortened in the groups A, B and D （all P〈0.05）.Compared with group A, the MAP and HR at T2 and T3 were significant-ly decreased in the groups B and C （all P〈0.05）;Compared with group D, the MAP and HR at T2 and T3 were significantly decreased in the groups A, B and C （all P〈0.05）.In the group A, there were 2 cases of hyoxemia, 4 cases of upper respir-atory tract obstruction, no nausea, vomiting or exudation;they were respectively 1, 0, 0 and 2 cases in the group B;0, 0,＆amp;nbsp;0 and 2 cases in the group C;and 1, 1, 1 and 6 cases in the gro

关 键 词：舒芬太尼 瑞芬太尼 腭裂 苏醒期躁动 

分 类 号：R782.2[医药卫生—口腔医学]