小剂量丙泊酚或氯胺酮对小儿扁桃体切除术麻醉苏醒后咳嗽的影响  

Effect of the low-dose propofol or ketamine on coughing in children treated with tonsillectomy after recovery from anesthesia

作　　者：张浩然[1] 张运淳[1] ZHANG Hao-ran;ZHANG Yun-chun(Department of Anesthesiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院麻醉科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2021年第5期642-644,648,共4页Journal of Bengbu Medical College

摘　　要：目的:观察小剂量丙泊酚或氯胺酮对小儿扁桃体切除术麻醉后咳嗽的影响。方法:选择择期行扁桃体切除术小儿90例,ASAⅠ~Ⅱ级,随机分为丙泊酚组(P组),氯胺酮组(K组),各45例。2组患儿于手术结束后分别给予静脉注射小剂量丙泊酚(0.5 mg/kg)和小剂量氯胺酮(0.5 mg/kg),待患儿手术结束入监护室记录拔管后各时间段T0(拔管时)~T1(拔管后5min)、T1~T2(拔管后10 min)、T2~T3(拔管后15 min)、T3~T4(拔管后20 min)、T4~T5(拔管后25 min)、T5~T6(拔管后30 min)咳嗽的发生率。分别于术后10、20、30、60 min以及2、4、8 h时间点记录术后疼痛评分,并记录患儿术后恶心呕吐的发生率。结果:P组各时间段咳嗽发生率均低于K组,术后10、20、30、60 min时间点疼痛评分均高于K组,术后恶心呕吐发生率低于K组,差异均有统计学意义(P<0.05~P<0.01)。结论:对于进行扁桃体切除术的儿童,在麻醉结束后静脉注射0.5 mg/kg的低剂量丙泊酚较注射0.5 mg/kg的低剂量氯胺酮能更有效地降低麻醉后咳嗽、恶心呕吐的发生率,但镇痛效果不如氯胺酮。Objective:To observe the effects of low dose propofol or ketamine on cough in children treated with tonsillectomy after recovery from anesthesia.Methods:Ninety ASAⅠ-Ⅱpatients scheduled by tonsillectomy were randomly divided into the propofol group(group P)and ketamine group(group K)(45 cases each group).The group P and group K were intravenously injected with low dose propofol(0.5 mg/kg)and ketamine(0.5 mg/kg)at the end of anesthesia,respectively.After the operation,the occurrence rates of cough in two groups were recorded at T0,T0-T1,T1-T2,T2-T3,T3-T4,T4-T5 and T5-T6[T0(at the time of extubation),T1(after 5 min of extubation),T2(after 10 min of extubation),T3(after 15 min of extubation),T4(after 20 min of extubation),T5(after 25 min of extubation)and T6(after 30 min of extubation)].The pain scores in two groups were recorded after 10 min,20 min,30 min,1 h,2 h,4 h and 8 h of operation,respectively.The incidence rate of postoperative vomiting in two groups were recorded.Results:The incidence rates of cough in group P at each time-point were lower than that in group K,the pain scores in group P after 10 min 20 min 30 min of operation were higher than that in group K,and the incidence rate of postoperative vomiting in group P was lower than that in group K(P<0.05 to P<0.01).Conclusions:For children treated with tonsillectomy,compared with 0.5 mg/kg of low-dose ketamine the intravenous injection of 0.5 mg/kg of low-dose propofol after anesthesia can effectively reduce the cough,and incidence rates of nausea and vomiting,but the analgesic effect of propofol is not as good as ketamine.

关 键 词：小儿全身麻醉 咳嗽 全身麻醉苏醒期 丙泊酚 氯胺酮 

分 类 号：R614.2[医药卫生—麻醉学]