七氟烷复合艾司氯胺酮在小儿扁桃体、腺样体手术中的应用效果观察  

Efficacy of Sevoflurane Combined with Esketamine in Children with Tonsillectomy and Adenoidectomy

作　　者：刘珍珍 黎健君 杨珮 陆立仁 区惠婷 Liu Zhenzhen;Li Jianjun;Yang Pei;Lu Liren;Ou Huiting(Nanhai District People’s Hospital,Guangdong Foshan 528255,China)

机构地区：[1]佛山市南海区人民医院,广东佛山528255

出　　处：《儿科药学杂志》2024年第10期42-45,共4页Journal of Pediatric Pharmacy

基　　金：2022年佛山市自筹经费类科技创新项目,编号2220001005731。

摘　　要：目的:观察七氟烷复合艾司氯胺酮在小儿扁桃体、腺样体手术中的应用效果。方法:选取2023年9月-2024年2月在我院拟行扁桃体、腺样体手术的患儿92例,依据随机数表法分为研究组与对照组各46例。对照组采取七氟烷复合舒芬太尼作为全麻药物的主要组成,研究组采取七氟烷复合艾司氯胺酮作为全麻药物的主要组成。比较两组患儿血流动力学、麻醉后监测治疗室(PACU)自主呼吸恢复时间、气管拔管时间、停留时间、麻醉时间、手术时间、麻醉苏醒质量及不良反应发生情况。结果:研究组术中不良反应总发生率4.35%,低于对照组的19.57%(P<0.05)。在PACU气管拔管时,研究组的平均动脉压、心率均高于对照组(P<0.05)。研究组自主呼吸恢复时间、气管拔管时间、PACU停留时间均较对照组短(P<0.05)。复苏后研究组的不良反应总发生率2.17%,低于对照组的15.22%(P<0.05)。苏醒后15 min,研究组改良加拿大东安大略儿童医院疼痛评分量表(m-CHEOPS)评分、儿童麻醉苏醒期谵妄(PAED)评分低于对照组(P<0.05)。结论:与传统方法(七氟烷复合舒芬太尼麻醉)相比,七氟烷复合艾司氯胺酮用于小儿扁桃体、腺样体手术,术中的血流动力学更加稳定,缩短术后复苏及PACU停留时间,减少了不良反应发生,改善了麻醉苏醒质量,患者认可度更高。Objective:To observe the application effects of sevoflurane combined with esketamine in children with tonsillectomy and adenoidectomy.Methods:From Sept.2023 to Feb.2024,totally 92 children undergoing tonsillectomy and adenoidectomy in our hospital were extracted to be divided into the research group and control group via the random number table method,with 46 cases in each group.The control group was treated with sevoflurane combined with sufentanil as the main component of general anesthesia,while the research group received sevoflurane combined with esketamine as the main component of general anesthesia.The hemodynamics,recovery time of spontaneous breathing in post-anesthesia care unit(PACU),tracheal extubation time,length of stay,anesthesia time,surgical time,anesthesia recovery quality and adverse drug reactions were compared between two groups.Results:The total incidence of intraoperative adverse drug reactions in the research group was 4.35%,lower than 19.57%in the control group(P<0.05).At the time of tracheal extubation in PACU,the mean arterial pressure and heart rate in the research group were higher than those in the control group(P<0.05).The recovery time of spontaneous breathing,extubation time and length of stay in PACU in the research group were shorter than those in the control group(P<0.05).After resuscitation,the total incidence of adverse drug reactions in the research group was 2.17%,lower than 15.22%in the control group(P<0.05).At 15 min after awakening,the modified Children’s Hospital of Eastern Ontario Pain Scale(m-CHEOPS)score and Pediatric Anesthesia Emergence Delirium(PAED)score in the research group were lower than those in the control group(P<0.05).Conclusion:Compared with the traditional method(sevoflurane combined with sufentanil anesthesia),sevoflurane combined with esketamine for children with tonsillectomy and adenoidectomy can make the intraoperative hemodynamics more stable,shorten the postoperative recovery and length of stay in PACU,reduce the occurrence of adverse drug reac

关 键 词：七氟烷 艾司氯胺酮 儿童 扁桃体、腺样体手术 

分 类 号：R726.1[医药卫生—儿科]