艾司氯胺酮对小儿斜视矫正术全身麻醉苏醒期躁动和术后恢复的影响  

Effects of esketamine on emergence agitation and postoperative recovery in children undergoing strabismus correction

作　　者：王晶晶 张伟[1] 金楠 WANG Jingjing;ZHANG Wei;JIN Nan(Department of Anesthesiology and Perioperative Medicine,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,郑州450052

出　　处：《临床与病理杂志》2023年第3期508-514,共7页Journal of Clinical and Pathological Research

摘　　要：目的:探讨艾司氯胺酮对小儿斜视矫正术全身麻醉苏醒期躁动(emergence agitation,EA)和术后恢复的影响。方法:选取2022年3月至2022年10月在郑州大学第一附属医院行斜视矫正术的200例患儿,随机分为对照组(n=100)与观察组(n=100)。麻醉诱导前,观察组予以艾司氯胺酮0.25 mg/kg静脉注射,对照组予以等量生理盐水静脉滴注;2组均予以相同的麻醉诱导和麻醉维持。记录2组手术一般情况;记录2组入室后(T0)、插管即刻(T1)、手术结束(T2)、拔管后(T3)心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)的水平;记录2组诱导期合作度评估量表(Induction Compliance Checklist,ICC)评分;记录2组拔管后10 min镇静-躁动量表(Sedation-Agitation Scale,SAS)以及儿童疼痛行为量表(Face,Legs,Activity,Cry,Consolability Behavioral Tool,FLACC)评分;记录2组EA发生情况。结果:相比对照组,观察组拔管时间、麻醉恢复室停留时间均显著缩短(均P<0.05)。与T0相比,2组T1和T2时的HR、MAP水平均显著降低(均P<0.05),T3时HR、MAP均无明显变化(均P>0.05);相比对照组,观察组T1和T2时的HR、MAP水平均显著增高(均P<0.05)。相比对照组,观察组麻醉诱导时ICC评分以及拔管10 min后SAS、FLACC评分均显著降低(均P<0.05)。相比对照组,观察组EA发生率显著降低(分别为9.00%和28.00%,P<0.05),且躁动严重程度减轻(P<0.05)。结论:麻醉诱导前使用艾司氯胺酮能够有效预防小儿斜视矫正术后EA的发生,有利于术后恢复。Objective:To investigate the effect of esketamine on emergence agitation(EA)and postoperative recovery in children undergoing strabismus surgery.Methods:A total of 200 patients undergoing elective strabismus correction in the First Affiliated Hospital of Zhengzhou University from March 2022 to October 2022 were randomly divided into a control group(n=100)and an observation group(n=100).Before anesthesia induction,the observation group was given intravenous injection of esketamine 0.25 mg/kg,and the control group was given intravenous infusion of the same amount of normal saline;both groups were given the same anesthesia induction and anesthesia maintenance.The surgery general situation of the 2 groups were recorded;the levels of heart rate(HR)and mean arterial pressure(MAP)were recorded after entering the operating room(T0),immediately after intubation(T1),at the end of operation(T2),after extubation(T3);the Induction Compliance Checklist(ICC)score of the 2 groups were recorded;the scores of Sedation-Agitation Scale(SAS)and Face,Legs,Activity,Cry,Consolability Behavioral Tool(FLACC)at 10 min after extubation in the 2 groups were recorded;the occurrence of EA in the 2 groups was recorded.Results:Compared with the control group,the extubation time and postanesthesia care unit residence time in the observation group was significantly shortened(both P<0.05).Compared with T0,the levels of HR and MAP at T1 and T2 in the 2 groups were significantly decreased(all P<0.05),there was no significant change in HR and MAP at T3(all P>0.05).Compared with the control group,the HR and MAP levels at T1 and T2 in the observation group were significantly higher(all P<0.05).Compared with the control group,the ICC score during anesthesia induction,SAS and FLACC scores at 10 min after extubation in the observation group were significantly lower(all P<0.05).Compared with the control group,the incidence of EA in the observation group was significantly lower(9.00%vs 28.00%,P<0.05),and the severity of EA was reduced(P<0.05).Conclusion:The

关 键 词：小儿斜视矫正术 艾司氯胺酮 苏醒期躁动 术后恢复 

分 类 号：R726.1[医药卫生—儿科]