口服、肌注与鼻腔内给咪达唑仑对小儿七氟烷麻醉恢复期躁动的影响  

Influences of orally taking, intramuscularly injecting, and intranasally giving midazolam on agitation in children recovering from sevoflurane anesthesia

作　　者：刘桂祯[1] 孙玉川[1] 刘斐[1] Liu Guizhen Sun Yuchuan Liu Fei(Department of Anesthesiology, Laiyang Central Hospital of Yantai City, Laiyang 265200, Chin)

机构地区：[1]烟台市莱阳中心医院麻醉科,265200

出　　处：《国际医药卫生导报》2017年第5期713-716,共4页International Medicine and Health Guidance News

摘　　要：目的对口服、肌注与鼻腔内给咪达唑仑对小儿七氟烷麻醉恢复期躁动的影响进行分析。方法选取在本院行扁桃体联合腺样体切除术治疗的患儿76例，按照随机数字表法将本批患者分为4组，分别为对照组（c组）、肌内注射咪达唑仑组（IM组）、鼻腔内给予咪达唑组（IN组）以及口服咪达唑仑组（O组），每组19例。C组在麻醉前30rain口服10％葡萄糖溶液10ml，IM组、O组、1N组咪达唑仑剂量分别为0．15、0．45、0．25mg·kg-1，利用七氟烷进行相应的麻醉诱导，并在静脉注射相应的瑞芬太尼以及七氟烷对其麻醉效果给与维持。对脱离父母的难易程度以及父母的满意度进行评分，EA发生情况采用患儿麻醉恢复期躁动表化评分表（PAED）进行评估。结果C组（1分：17例；2分：2例；3分：0例；4分：0例）与O组（1分：0例；2分：15例；3分：4例；4分：0例）、IN组（1分：0例；2分：6例；3分：13例；4分：0例）以及IM组（1分：0例；2分：7例；3分：12例；4分：0例）相比，其在脱离父母难易程度、父母满意度所获评分提升，其相应的PAED评分及EA的发生率均降低（均P〈0．05）；与O组相比，其相应的脱离父母难易程度上的评分明显升高，在父母的满意度方面的评分降低（均P〈0．05），其在EA发生率以及PAED的评分上差异均无统计学意义（均P〉0．05）。结论通过口服、肌注与鼻腔内给相应的咪达唑仑，对于预防小儿七氟烷EA的发生在效果上具有相似之处，并且通过口服的方式用药更容易被接受。Objective To analyze the influences of orally taking, intramuscularly injecting, and intranasaUy giving midazolam on agitation in children recovering from sevoflurane anesthesia. Methods 76 children undergoing tonsillectomy and adenoidectomy at our hospital were chosen and divided into a control group （group C）, an intramuscularly injecting midazolam group （group IM）, a nasal administration of midazolam group （group IN）, and an orally taking midazolam group （group O）, 19 cases for each group. Group C orally took 10 ml 10% glucose solution 30 min before anesthesia. Group IM were nasally administrated 0.15 mg·kg-1 midazolam; group IN were intramuscularly injected 0.25 mg·kg-1 midazolam; and group O orally took 0.45 mg·kg-1 midazolam. Sevoflurane was used for anesthesia induction. The anesthesia was maintained intravenously injecting remifentanil and sevoflurane. The difficulty from the parents and the parents＇ satisfaction were scored. The occurrence of EA in the patients was assessed by anesthesia recovery period agitation table （PAED）. Results The scores of difficulty from the parents and the parents＇ satisfaction were lower and and the score and the incidence of EA were higher in group C than in group O, group IN, and group IM. Conclusion Orally taking, intramuscularly injecting, and intranasally giving midazolam have the same effect in the prevention of EA in children recovering from sevoflurane anesthesia, but oral medication is more easily accepted.

关 键 词：口服 肌注 咪达唑仑 七氟烷 影响 

分 类 号：R726.1[医药卫生—儿科]