预防性应用小剂量艾司氯胺酮对行扁桃体腺样体手术患儿全麻苏醒期躁动的影响  

The effect of prophylactic use of low-dose esketamine on restlessness during recovery from general anesthesia in children undergoing tonsil adenoidectomy

作　　者：金名花 Jin Minghua(Shangrao People's Hospital,Jiangxi 334000)

机构地区：[1]上饶市人民医院,江西334000

出　　处：《天津药学》2024年第2期47-50,共4页Tianjin Pharmacy

摘　　要：目的:探究预防性应用小剂量艾司氯胺酮对行扁桃体腺样体手术患儿全麻苏醒期躁动的影响。方法:采用随机数字表法将2022年1月—2023年7月于本院行扁桃体腺样体切除术患儿80例分为两组,各40例。对照组采用传统全麻方案,研究组予以小剂量艾司氯胺酮全麻干预。比较两组围术期指标、不同时点血流动力学指标水平、苏醒期躁动及谵妄发生率。结果:研究组拔管时间短于对照组(P<0.05);两组麻醉时间及手术时间比较,差异无统计学意义(P>0.05)。T0及T4时,两组心率(HR)及平均动脉压(MAP)比较,差异无统计学意义(P>0.05);T1、T2时,研究组MAP及HR均高于对照组(P<0.05),研究组T3时MAP水平高于对照组(P<0.05),但HR水平两组比较,差异无统计学意义(P>0.05)。研究组苏醒期躁动及苏醒期谵妄发生率均低于对照组(P<0.05)。结论:扁桃体腺样体手术中予以预防性应用小剂量艾司氯胺酮能够有效缩短患儿拔管时间,稳定术中血流动力学,降低苏醒期躁动及谵妄发生率,利于提升苏醒期质量,值得推广应用。Objective:To investigate the effect of prophylactic use of low-dose esketamine on restlessness during general anesthesia in children undergoing tonsil adenoid surgery.Methods:A random number table method was used to divide80 children who underwent tonsillectomy in our hospital from January 2022 to July 2023 into two groups,with 40 cases in each group.The control group received traditional general anesthesia,whereas the study group received low-dose esketamine anesthesia.The perioperative indexes,hemodynamic indexes at different time points,and incidence of agitation and delirium during the recovery period were compared between the two groups.Results:Extubation time was shorter in the study group than in the control group(P<0.05).There were no significant differences in anesthesia and surgical time between the two groups(P>0.05).At T0 and T4,there were no significant differences in heart rate(HR)and mean arterial pressure(MAP)between the two groups(P>0.05).At T1 and T2,MAP and HR levels in the study group were higher than those in the control group(P<0.05).At T3,the MAP levels in the study group were higher than those in the control group(P<0.05),but there was no statistically significant difference in the HR levels between the two groups(P>0.05).The incidence of agitation and delirium in the study group was lower than that in the control group(P<0.05).Conclusion:The prophylactic application of low-dose esketamine in tonsil adenoid surgery can effectively shorten the time of extubation,stabilize intraoperative hemodynamics,and reduce the incidence of agitation and delirium during the recovery period,which is conducive to improving the quality of the recovery period and is worthy of popularization.

关 键 词：扁桃体腺样体切除术 全麻手术 艾司氯胺酮 小剂量 苏醒期躁动 

分 类 号：R971.2[医药卫生—药品]