小剂量舒芬太尼在小儿内镜下低温等离子扁桃体和腺样体切除术后预防苏醒期躁动的临床效果  

Clinical effect of low-dose sufentanil on the prevention of emergence agitation after endoscopic lowtemperature plasma tonsillectomy and adenoidectomy in children

作　　者：王丹丹 WANG Dan-dan(Department of Anesthesiology,Xuzhou Children's Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市儿童医院麻醉科,221000

出　　处：《中国现代药物应用》2023年第4期52-55,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨小剂量舒芬太尼在小儿内镜下低温等离子扁桃体和腺样体切除术后预防苏醒期躁动的效果。方法80例在小儿内镜下实施低温等离子扁桃体和腺样体切除术的患儿,依据入院编号的奇偶性随机分为对照组与观察组,各40例。观察组在手术结束阶段注射小剂量舒芬太尼,对照组注射丙泊酚。比较两组临床相关指标[拔管时间、苏醒时间、苏醒期躁动评分量表(PAED)评分]、不同时间[麻醉诱导前5 min(T0)、注射舒芬太尼或丙泊酚后(T1)、苏醒时(T2)、苏醒后30 min(T3)、苏醒后60 min(T4)、苏醒后120 min(T5)]的应激指标[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))]、苏醒后躁动评分及不良反应发生情况。结果两组苏醒时间、拔管时间比较,差异无统计学意义(P>0.05);观察组PAED评分(3.01±0.31)分低于对照组的(5.63±0.42)分,差异有统计学意义(P<0.05)。T0、T1时,两组MAP、HR比较差异无统计学意义(P>0.05);T2~T5时,观察组MAP、HR低于对照组,差异有统计学意义(P<0.05);T0~T5时,两组SpO_(2)比较差异无统计学意义(P>0.05)。苏醒后30、60、120 min,观察组躁动率分别为20.00%、5.00%、0,呕吐率分别为2.50%、0、0,均低于对照组的50.00%、20.00%、10.00%与17.50%、10.00%、12.50%,差异均有统计学意义(P<0.05);两组呼吸抑制发生率比较差异无统计学意义(P>0.05)。结论在小儿内镜下低温等离子扁桃体和腺样体切除术后实施小剂量舒芬太尼可有效降低患儿在苏醒期的应激反应,可以促进其保持体征平稳,继而减少躁动等不良情况的发生率,而且具有较高的安全性。Objective To discuss the effect of low-dose sufentanil on the prevention of emergence agitation after endoscopic low-temperature plasma tonsillectomy and adenoidectomy in children.Methods A total of 80 children who underwent endoscopic low-temperature plasma tonsillectomy and adenoidectomy were randomly divided into control group and observation group according to the parity of admission number,with40 cases in each group.The observation group was injected with low-dose sufentanil at the end of the operation,while the control group was injected with propofol.Both groups were compared in terms of clinically relevant indexes[extubation time,recovery time,paediatric anaesthesia emergence delirium(PAED)],stress indicators[mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2))]at different time points[5 min before anesthesia induction(T0),after sufentanil or propofol injection(T1),at recovery(T2),30 min after recovery(T3),60 min after recovery(T4),and 120 after recovery],agitation score after recovery and occurrence of adverse reactions.Results There was no statistically significant difference between the two groups in terms of recovery time and extubation time(P>0.05).The PAED score(3.01±0.31)points of the observation group was lower than(5.63±0.42)points of the control group,and the difference was statistically significant(P<0.05).At T0 and T1,there was no statistically significant difference in MAP and HR between the two groups(P>0.05).At T2-T5,the MAP and HR in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).At T0-T5,there was no statistically significant difference in SpO_(2)between the two groups(P>0.05).At 30,60 and 120 min after recovery,the agitation rate in the observation group were20.00%,5.00%,0,and the vomiting rate were 2.50%,0 and 0,which were lower than 50.00%,20.00%,10.00%vs 17.50%,10.00%,12.50%in the control group,and the differences were statistically significant(P<0.05).There was no statistically signifi

关 键 词：扁桃体和腺样体切除术 麻醉苏醒 躁动 舒芬太尼 

分 类 号：R726.1[医药卫生—儿科]