艾司氯胺酮复合丙泊酚在小儿扁桃体摘除术中镇静作用及麻醉诱导合作度研究  

Study on Sedative Effect and Anesthetic Induction Cooperation of Esketamine Combined with Propofol in Pediatric Tonsillectomy

作　　者：李嘉 韩芳 张祥飞 李军 LI Jia;HAN Fang;ZHANG Xiangfei;LI Jun(Department of Pharmacy,North Anhui Vocational College of Health,Suzhou 234000,China;Department of Anesthesia,Suzhou First People’s Hospital,Suzhou 234000,China;School of Pharmacy,Shandong First Medical University,Jinan 250200,China)

机构地区：[1]皖北卫生职业学院药学系,安徽宿州234000 [2]宿州市第一人民医院麻醉科,安徽宿州234000 [3]山东第一医科大学药学院,山东济南250200

出　　处：《湖北民族大学学报（医学版）》2023年第1期61-64,72,共5页Journal of Hubei Minzu University(Medical Edition)

基　　金：安徽省教育厅自然科学重点项目(KJ2021A1570)。

摘　　要：目的观察艾司氯胺酮复合丙泊酚在小儿扁桃体摘除术中的镇静作用及麻醉诱导合作度。方法选取宿州市第一人民医院麻醉科2021年4月-2022年10月行扁桃体全麻摘除术的患儿112例,依据入院时间顺序,分为对照组和研究组,每组各56例,对照组给予舒芬太尼+丙泊酚麻醉方案,研究组则接受艾司氯胺酮+丙泊酚麻醉方案。记录并比较两组患儿麻醉诱导前(T_(1))、亲子分离时(T_(2))及麻醉诱导时(T_(3))3个时点的焦虑状况(Cm-YPAS评分);比较两组患儿苏醒后1 h(T_(4))、3 h(T_(5))、6 h(T_(6))、12 h(T_(7))、24 h(T_(8))5个时点的镇静评分(Ramsay镇静评分);比较两组患儿T_(3)时的麻醉诱导合作度(ICC评分)。结果①两组患儿在T_(1)、T_(2)、T_(3)3个时点均出现焦虑状况,T_(3)组Cm-YPAS评分高于T_(2)、T_(1)组,T_(2)组Cm-YPAS评分高于T_(1)组(P<0.05);②两组患儿Ramsay评分在T_(4)、T_(5)、T_(6)、T_(7)4个时间点均呈上升趋势,研究组上升幅度大于对照组(P<0.05)。两组T_(8)时Ramsay评分均低于T_(7),呈下降趋势,研究组下降幅度低于对照组(P<0.05);(3)研究组T_(3)时ICC评分显著低于对照组(P<0.05)。结论艾司氯胺酮复合丙泊酚在小儿扁桃体摘除术中镇静效果好,能有效缓解患儿焦虑状态,且患儿麻醉诱导合作度高,可作为小儿扁桃体摘除术麻醉方案的优先选择之一。Objective To observe the sedative effect of Esketamine combined with Propofol in children tonsillectomy and the cooperation degree of anesthesia induction.Methods 112 children who underwent tonsillectomy under general anesthesia from April 2021 to October 2022 in the Department of Anesthesiology of the First People’s Hospital of Suzhou City were selected.According to the order of admission, they were divided into control group and study group, with 56 cases in each group.The control group was given Sufentanil and Propofol anesthesia scheme, while the study group was given Esketamine and Propofol anesthesia scheme.The anxiety status(Cm YPAS score) of the two groups at three time points before anesthesia induction(T_(1)),at the time of parent-child separation(T_(2)) and at the time of anesthesia induction(T_(3)) were recorded and compared.The sedation scores(Ramsay sedation score) of the two groups were compared at five time points: 1 h(T_(4)),3 h(T_(5)),6 h(T_(6)),12 h(T_(7)),24 h(T_(8)) after awakening.The cooperation degree of anesthesia induction(ICC score) at T_(3)was compared between the two groups.Results(1) The children in the two groups showed anxiety at T_(1),T_(2)and T_(3) time points, and the Cm YPAS scores were T_(3)>T_(2)>T_(1).There was significant difference within the group(P<0.05),but there was no significant difference between the study group and the control group(P>0.05).(2) Ramsay score of children in the two groups showed an upward trend at T_(4),T_(5),T_(6)and T_(7) time points, but the increase in the study group was greater than that in the control group, with significant difference between groups(P<0.05).The Ramsay scores of the two groups at T_(8) were lower than those at T_(7),showing a downward trend, but the decline of the study group was weaker than that of the control group, with significant differences between the groups(P<0.05).(3) At T_(3),the ICC score of the study group was(1.43±1.35),which was much lower than that of the control group(2.05±1.65),with significant difference

关 键 词：艾司氯胺酮 扁桃体摘除术 镇静 麻醉诱导合作度 

分 类 号：R614[医药卫生—麻醉学]