不同药物对小儿扁桃体腺样体切除术后镇静镇痛效果的比较  

Comparison of Sedative and Analgesic Effects of Different Drugs in Children after Adenoidectomy and Tonsillectomy

作　　者：谢照明 XIE Zhaoming(Xiamen Children's Hospital,Xiamen 361000,China)

机构地区：[1]厦门市儿童医院复旦大学附属儿科医院厦门分院,福建厦门361000

出　　处：《中外医学研究》2020年第33期54-57,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较氟比洛芬酯、氢吗啡酮、右美托咪定对扁桃体腺样体切除术术后镇痛、镇静的效果。方法:选择笔者所在医院2019年6-11月行扁桃体腺样体切除术患儿90例,采用随机数字表法将其分为氟比洛芬酯组(A组)、氢吗啡酮组(B组)、右美托咪定组(C组),每组30例。比较三组麻醉及术后镇痛、镇静效果。结果:三组T0、T1、T3、T4时心率比较差异均无统计学意义(P>0.05),C组T2时心率低于A、B组,差异有统计学意义(P<0.05)。三组T1、T2、T3、T4时平均动脉压均低于T0时,差异有统计学意义(P<0.05)。三组不同时间点平均动脉压比较差异均无统计学意义(P>0.05)。三组自主呼吸恢复时间及拔管时间比较差异均无统计学意义(P>0.05)。三组拔管后不同时间点VAS镇痛评分比较差异均无统计学意义(P>0.05)。C组拔管后不同时间点镇静评分均优于A、B组,差异有统计学意义(P<0.05)。结论:氟比洛芬酯、氢吗啡酮、右美托咪定均能提供较好的术后镇痛,右美托咪定相对其他两种药物能够提供更好的术后镇静效果,更适用于扁桃体腺样体切除术患儿。Objective:To compare the analgesic and sedative effects of Flurbiprofen Axetil,Hydromorphone and Dextrometosine after tonsillectomy.Method:A total of 90 children who underwent tonsillectomy from June to November 2019 in our hospital were selected and divided into the Flurbiprofen Axetil group(group A),Hydromorphone group(group B)and Dextrometosine group(Group C)by random number table method,with 30 patients in each group.The anesthesia,postoperative analgesic and sedative effects were compared among the three groups.Result:There were no significant differences in heart rate at T0,T1,T3 and T4 among the three groups(P>0.05).The heart rate of group C at T2 was lower than that of group A and group B,the difference was statistically significant(P<0.05).The mean arterial pressure at T1,T2,T3 and T4 in three groups were lower than that at T0,the differences were statistically significant(P<0.05).There were no significant differences in mean arterial pressure among the three groups at different time points(P>0.05).There were no significant differences in the recovery time of spontaneous breathing and extubation time among the three groups(P>0.05).There were no significant differences in VAS analgesic scores among the three groups at different time points after extubation(P>0.05).The sedative score of group C at different time points after extubation were significantly better than those of group A and group B,the differences were statistically significant(P<0.05).Conclusion:Flurbiprofen Axetil,Hydromorphone and Dextrometosine can all provide better postoperative analgesic,and Dextrometosine can provide better postoperative sedative effect than the other two drugs,and it is more suitable for children undergoing tonsillectomy.

关 键 词：氟比洛芬酯 氢吗啡酮 右美托咪定 扁桃体腺样体摘除术 小儿 术后镇痛 术后镇静 

分 类 号：R726.1[医药卫生—儿科]