不同剂量艾司氯胺酮在儿童隐匿阴茎矫正手术中的应用  

Application of different doses of esketamine in children with concealed penile correction surgery

作　　者：袁超[1] 周林 高宁阳 孙铭佩 何景优 胡祖荣[1] YUAN Chao;ZHOU Lin;GAO Ning-yang;SUN Ming-pei;HE Jing-you;HU Zu-rong(Department of Anesthesiology,Guangdong Women and Children Hospital,Guangzhou GUANGDONG 510000,China)

机构地区：[1]广东省妇幼保健院,广东广州510000

出　　处：《中国新药与临床杂志》2022年第7期422-425,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：广东省中医药局项目(20211052)。

摘　　要：目的探讨不同剂量艾司氯胺酮在儿童隐匿阴茎矫正手术中的应用效果。方法选择4~12岁拟行隐匿阴茎矫正手术的患儿120例,采用双盲、随机方法均分为4组。麻醉诱导均给予丙泊酚、顺阿曲库铵静脉注射,SE_(0)组加用舒芬太尼0.2μg·kg^(-1),SE_(1)组、SE_(3)组、SE_(5)组加用舒芬太尼0.2μg·kg^(-1)复合艾司氯胺酮0.1、0.3、0.5 mg·kg^(-1)。4组均给予0.2%罗哌卡因0.5 mL·kg^(-1)行骶管阻滞,术中以1.3 MAC七氟烷维持,舒芬太尼1μg·kg^(-1)·d^(-1)术后静脉镇痛,必要时追加舒芬太尼0.1μg·kg^(-1)。记录4组舒芬太尼用量,监测患儿的心率、平均动脉压、WongBaker镇痛评分、Ramsay镇静评分,记录复苏时长和不良反应发生情况。结果与SE_(0)组、SE_(1)组比较,SE_(3)组和SE_(5)组舒芬太尼追加量、总用量减少,差异有显著意义(P<0.05),舒芬太尼诱导量比较无显著差异(P>0.05);SE_(0)组与SE_(1)组、SE_(3)组与SE_(5)组舒芬太尼用量比较无显著差异(P>0.05)。与SE_(3)组比较,SE_(0)组、SE_(1)组、SE_(5)组拔除喉罩后10 min镇静评分升高,且复苏时长延长,差异有显著意义(P<0.05);SE_(0)组、SE_(1)组、SE_(5)组各观察时点镇静评分比较无显著差异,复苏时长组间比较也无显著差异(P>0.05)。术后48 h内各观察时点镇痛评分、心率、平均动脉压组间比较均无显著差异(P>0.05),不良反应发生率组间比较也无显著差异(P>0.05)。结论艾司氯胺酮0.3 mg·kg^(-1)静脉诱导可减少儿童隐匿阴茎矫正手术舒芬太尼用量,镇痛、镇静效果满意,无明显不良反应。AIM To investigate the effects of different doses of esketamine in children with concealed penile correction surgery.METHODS One hundred and twenty pediatric patients aged 4 to 12 years who planned to undergo concealed penile correction surgery were randomly divided into four groups by double-blind method.Propofol and cisatracurium were given intravenously during anesthesia induction,and sufentanil 0.2μg·kg^(-1) was added in SE_(0) group,while sufentanil 0.2μg·kg^(-1) combined with esketamine 0.1,0.3 and 0.5 mg·kg^(-1) were added in SE_(1) group,SE_(3) group and SE_(5) group.All pediatric patients were given 0.2%ropivacaine 0.5 mL·kg^(-1) for sacral canal block,and then were maintained with 1.3 MAC sevoflurane and postoperative intravenous analgesia with sufentanil 1μg·kg^(-1).And if it was necessary,sufentanil 0.1μg·kg^(-1) should be added.The dosage of sufentanil,duration of resuscitation,occurrence of adverse reactions,heart rate,mean arterial pressure,Wong-Baker analgesia score and Ramsay sedation score in the four groups were monitored and recorded.RESULTS The dosage of additional sufentanil and total sufentanil in the SE_(3) group and SE_(5) group decreased significantly compared with the SE_(0) group and SE_(1) group(P<0.05),but there was no significant difference in the dosage of sufentanil used for induction among four groups(P>0.05).There was no significant difference in the dosage of sufentanil between SE_(0) group and SE_(1) group,SE_(3) group and SE_(5) group(P>0.05).Compared with the SE_(3) group,sedation score increased 10 minutes after laryngeal mask removal in the SE_(0) group,SE_(1) group and SE_(5) group,and the duration of resuscitation was prolonged(P<0.05).There were no significant difference in sedation score at each observation time point and the length of resuscitation among SE_(0) group,SE_(1) group and SE_(5) group(P>0.05).The analgesia score,heart rate,mean arterial pressure,incidence of adverse reactions were no significant difference among the groups within 48 hours after o

关 键 词：艾司氯胺酮 舒芬太尼 阴茎疾病 儿童 隐匿阴茎矫正手术 

分 类 号：R971[医药卫生—药品]