预防应用地佐辛对扁桃体切除手术患儿七氟醚吸入麻醉苏醒质量的影响  

Effects of Pretreatment with Dezocine on Recovery Quality for Tonsillectomy in Children Undergoing Sevoflurane Inhalation Anesthesia

作　　者：赵保军[1] 黄佳洋[2] 

机构地区：[1]湖北省医学会,湖北武汉430071 [2]湖北省鄂州市中心医院麻醉科,湖北鄂州436000

出　　处：《武汉大学学报（医学版）》2016年第6期1027-1030,共4页Medical Journal of Wuhan University

摘　　要：目的:观察预防应用地佐辛对口咽部手术患儿七氟醚吸入麻醉苏醒期Riker评分、可抚慰性(FLACC)评分、躁动发生率的影响,探讨其改善苏醒期质量的效果。方法:选择ASAⅠ-Ⅱ级择期在七氟醚吸入麻醉下行扁桃体摘除术的患儿60例,年龄4-10岁,体重13-34kg,采用随机数字表法,将其分为对照组和观察组,每组30例。两组麻醉诱导后行气管插管,机械通气,麻醉维持:吸入七氟醚2%-4%,静脉持续泵注瑞芬太尼0.5μg/(kg·min),手术结束前约20min对照组静脉滴注生理盐水,观察组静脉滴注地佐辛0.1mg/kg。观察并记录两组患儿麻醉诱导前(T0)、手术结束时(T1)、气管导管拔除时(T2)、气管导管拔除后5,10 min(T3,T4)时的平均动脉压(MAP)、心率(HR)。观察并记录患儿有咽部吞咽反射时进行Riker镇静躁动评分,于拔除气管导管后20min时进行FLACC评分。结果:与对照组(Ⅰ组)比较,观察组(Ⅱ组)T2-4时MAP、HR、Riker镇静躁动评分、FLACC评分、躁动发生率下降,差异有统计学意义(P<0.05)。结论:预防性应用0.1mg/kg地佐辛可明显改善扁桃体切除手术患儿七氟醚吸入麻醉苏醒质量。Objective：To observe the effects of pretreatment with dezocine on Riker score,FLACC score and agitation occurrence rate for oropharyngeal surgery in children undergoing sevoflurane inhalation anesthesia,and to explore the effect of improving the quality of recovery period.Methods：Sixty children undergoing sevoflurane anesthesia tonsillectomy at ASAⅠ-Ⅱlevel,aged 4to10 years old,weighing 13-34 kg,were randomly divided into control group（groupⅠ）and Dizocine group（groupⅡ）with 30 cases in each.Two groups of anesthesia were induced by endotracheal intubation,mechanical ventilation,anesthesia maintenance with sevoflurane inhalation 2%-4%,continuous intravenous infusion of remifentanil 0.5μg/（kg·min）.About 20 minutes before the end of surgery,groupⅠ was given by intravenous infusion of normal saline,while groupⅡ was given by intravenous infusion of dezocine 0.1 mg/kg.Two groups of children were observed and recorded MAP and HR before induction of anesthesia（T0）,at the end of surgery（T1）,tracheal extubation（T2）,and after extubation 5,10min（T3,T4）.The children performed Riker sedation agitation scale throat were under observation and record when swallowing reflex.Facial expressions 20 minutes after extubation,crying,activities,physical activity,can be soothingly（FLACC）scored.Results：Compared with groupⅠ,MAP,HR,Riker sedation agitation score,FLACC rates decreased in group Ⅱ at T2-4,so did the incidence of agitation（P〈0.05）.Conclusion：Prophylactic 0.1mg/kg dezocine obviously improves awakening quality for tonsillectomy in children undergoing sevoflurane anesthesia.

关 键 词：地佐辛 七氟醚 吸入麻醉 苏醒期 躁动 

分 类 号：R614.2[医药卫生—麻醉学]