右旋美托咪啶和曲马多对儿童扁桃体切除术后疼痛、躁动和拔管质量的影响  

Effects of Dexmedetomidine and Tramadol on Postoperative Pain,Agitation and Extubation Quality in Children Undergoing Tonsillectomy

作　　者：钟国城 黄家慧 刘远辉[1] ZHONG Guocheng;HUANG Jiahui;LIU Yuanhui(Huizhou Central People’s Hospital,Huizhou 516001,China;不详)

机构地区：[1]惠州市中心人民医院,广东惠州516001

出　　处：《中外医学研究》2021年第24期30-33,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：惠州市医疗卫生类科技计划项目(2019Y031)。

摘　　要：目的:探讨右旋美托咪啶和曲马多对扁桃体切除术患儿术后疼痛、躁动、血流动力学参数和拔管质量的影响。方法:选择2019年8月-2020年8月在笔者所在医院择期行扁桃体切除术的儿科患儿60例,采用随机数字表法将其分为右旋美托咪啶组(D组)和曲马多组(T组),每组30例。D组接受右旋美托咪啶治疗,T组接受曲马多治疗。比较两组诱导前(T_(0))、诱导后20 min(T_(1))、研究药物输注前(T_(2))、研究药物输注5 min后(T_(3))、研究药物输注10 min后(T_(4))、拔管后1 min(T_(5))、拔管后15 min(T_(6))、拔管后30 min(T_(7))的平均动脉压(MAP)和心率(HR)。比较两组拔管时间、睁眼时间、术后疼痛、躁动及不良事件发生情况。比较两组拔管后1 min(T_(5))、15 min(T_(6))、30 min(T_(7))Riker镇静-躁动评分(SAS)和疼痛点系统评分(PPSS)。结果:D组T_(3)、T_(4)、T_(5)、T_(6)、T_(7)时的心率明显低于T_(0)时(P<0.05);T_(3)、T_(4)、T_(5)、T_(6)、T_(7)时,D组HR均明显低于T组,差异有统计学意义(P<0.05)。两组T_(3)、T_(4)时MAP均低于本组T_(0)时(P<0.05);两组间各个时间点MAP比较,差异均无统计学意义(P>0.05)。D组拔管后屏息、咳嗽和血氧去饱和发生率为3.3%,低于T组的20.0%,差异有统计学意义(P<0.05)。D组拔管后恶心、呕吐发生率为3.3%,低于T组的20.0%,差异有统计学意义(P<0.05)。D组拔管时间和睁眼时间明显长于T组,差异有统计学意义(P<0.05)。T_(5)、T_(6)、T_(7)时,D组SAS评分、PPSS评分均明显低于T组,差异有统计学意义(P<0.05)。结论:与曲马多相比,右旋美托咪啶能更有效地控制腺扁桃体切除术患儿术后疼痛和躁动。此外,尽管右旋美托咪啶可增加拔管时间,但其拔管质量较好。Objective:To investigate the effects of Dexmedetomidine and Tramadol on postoperative pain,agitation,hemodynamic parameters and extubation quality in children undergoing tonsillectomy.Method:A total of 60 pediatric children who underwent tonsillectomy in our hospital from August 2019 to August 2020 were selected,and divided into the Dexmedetomidine group(group D)and the Tramadol group(group T)by random number table method,with 30 cases in each group.Group D received Dexmedetomidine,and group T received Tramadol.The mean arterial pressure(MAP)and heart rate(HR)of the two groups were compared before induction(T0),20 min after induction(T_(1)),before study drug infusion(T_(2)),5 min after study drug infusion(T_(3)),10 min after study drug infusion(T_(4)),1 min after extubation(T_(5)),15 min after extubation(T_(6))and 30 min after extubation(T_(7)).Extubation time,eye opening time,postoperative pain,agitation and the occurrence of adverse events were compared between the two groups.Riker sedation-agitation score(SAS)and pain point system score(PPSS)at 1 min after extubation(T_(5)),15 min after extubation(T_(6))and 30 min after extubation(T_(7))were compared between the two groups.Result:The heart rate of group D at T_(3),T_(4),T_(5),T_(6) and T_(7) was significantly lower than that at t0(P<0.05).At T_(3),T_(4),T_(5),T_(6) and T_(7),HR of group D was significantly lower than that of group T,the difference was statistically significant(P<0.05).The MAP at T_(3) and T_(4) was lower than that at T0 in the two groups(P<0.05).There was no significant difference in MAP between the two groups at each time point(P>0.05).The incidence of breath holding,cough and blood oxygen desaturation after extubation in group D was 3.3%,which was lower than 20.0%in group T,and the difference was statistically significant(P<0.05).The incidence of nausea and vomiting after extubation was 3.3%in group D,which was lower than 20.0%in group T,the differences were statistically significant(P<0.05).The extubation time and eye opening time of group

关 键 词：腺扁桃体切除术 右旋美托咪啶 曲马多 

分 类 号：R726.1[医药卫生—儿科]