超前镇痛对小儿七氟醚全麻苏醒期躁动的影响  

Effect of preemptive analgesia on emergence agitation after sevoflurane anesthesia in pediatric patients

作　　者：张荣[1] 刘吉平[1] 董志芳[1] 倪如飞[1] 武建[1] 刘国栋[1] 

机构地区：[1]广东省佛山市妇幼保健院麻醉科,佛山528000

出　　处：《新疆医学》2017年第3期256-260,共5页Xinjiang Medical Journal

基　　金：佛山市科技局攻关计划项目(2014AB00367)

摘　　要：目的观察比较超前镇痛对小儿全麻苏醒期躁动的影响。方法选择择期行腹腔镜下疝囊高位结扎术及鞘状突高位结扎术2~7周岁患儿,采用单中心、分层、随机、双盲设计;患儿按照随机数字表随机分为四组,氟比洛芬酯组(K)、曲马多组(Q)、芬太尼组(F)和空白组(N),每组40人于手术前10分钟缓慢静脉注射给药,具体方案为:K组氟比洛芬酯1mg/kg;Q组曲马多1mg/kg;F组芬太尼2 ug/kg;N组生理盐水3 mL。观察并记录患儿转入术后恢复室的疼痛程度和躁动程度。结果 K组、Q组和F组患儿拔管时和清醒时的MAP和HR低于N组患儿,与麻醉前和停药时比较差异有统计学意义(P<0.05)。N组在各时点的疼痛评分和严重躁动的比例均高于K组、Q组和F组患儿(P<0.05)。结论超前镇痛有助于减少小儿苏醒期躁动的发生。Objective To evaluate the effect of preemptive analgesia on emergence agitation in children. Methods Children （2-7 years） undergoing elective laparoscopic inguinal hernia repair through high ligation of hernia sac or laparoscopic high ligatioo of processus vaginalis were enrolled in this single center, stratified, randomized, double blind study. Children were randomly assigned to the following groups： flurbiprofen axetil group （K）, tramadol group （Q）, fentanyl group （F） , and control group （N）. Flurhiprofen（lmgikg）, tramadol （lmg/kg）,fentanyl （2 μg/kg） and normal saline （3ml） were slowly given intravenously 10 minutes before surgery respectively. Emergence agitation and degree of pain after operation were recorded. Results Children in K group, Q group and F group had significant lower MAP and HR during they were in extubation and being awake compared with N group, which were also significantly different from those before anesthesia and after drugs were withdrawn. Pain score and the incidence of severe agitation were significant higher in N group at each time point （P〈0.05）. Conclusion preemptive analgesia can effectively reduce the occurrence of emergence agitation in children.

关 键 词：超前镇痛 七氟醚 全身麻醉 躁动 

分 类 号：R614[医药卫生—麻醉学]