艾司氯胺酮与氯胺酮分别复合丙泊酚麻醉对儿童扁桃体切除术后苏醒期躁动和疼痛的影响  

Effect of Esketamine Versus Ketamine Combined with Propofol Anesthesia on Emergence Agitation and Pain in Children After Tonsillectomy

作　　者：韩芳 李嘉 张祥飞 HAN Fang;LI Jia;ZHANG Xiangfei(Department of Pharmacy,North Anhui Vocational College of Health)

机构地区：[1]皖北卫生职业学院药学系,安徽宿州234000 [2]安徽省宿州市第一人民医院麻醉科

出　　处：《长治医学院学报》2025年第1期52-56,共5页Journal of Changzhi Medical College

基　　金：安徽省教育厅自然科学重点项目(KJ2021A1570)。

摘　　要：目的:探讨艾司氯胺酮与氯胺酮分别复合丙泊酚麻醉对儿童扁桃体切除术后苏醒期躁动和疼痛的影响。方法:回顾性分析行扁桃体切除术的112例扁桃体肥大儿童,根据麻醉用药方案分为观察组与对照组,各56例。2组均为全凭静脉麻醉,观察组采用艾司氯胺酮复合丙泊酚,对照组采用氯胺酮复合丙泊酚。比较2组患儿苏醒期躁动评分(PAED)、疼痛评分(FLACC)、拔管时间和苏醒时间、贝利婴幼儿发展量表第3版评分(BSIDⅢ)、平均动脉压(MAP)、心率、体温、不良反应。结果:术毕30 min(T 5)时间点观察组PAED评分为(8.20±0.77)分,低于对照组的(8.59±1.09)分,T 5时间点的FLACC评分为(2.41±0.63)分,低于对照组的(2.73±0.73)分(P<0.05);观察组患儿拔管时间和苏醒时间均低于对照组(P<0.05);术后6 h、24 h观察组BSIDⅢ评分均高于对照组(P<0.05);观察组患儿气管插管时(T_(2))、插管后30 min(T_(3))时间点的MAP、心率均高于对照组(P<0.05);观察组和对照组T_(1)~T_(4)时段的体温组间比较差异均无统计学意义(P>0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:与氯胺酮相比,艾司氯胺酮复合丙泊酚麻醉可减少儿童扁桃体切除术后苏醒期躁动、减轻疼痛、改善认知功能,术中血流动力学更加平稳。Objective:To investigate the effects of ketamine and ketamine combined with propofol anesthesia on agitation and pain during the recovery period after tonsillectomy in children.Methods:A retrospective analysis was conducted on 112 children with tonsillectomy who underwent tonsillectomy.According to the anesthesia medication plan for the children,they were divided into a study group and a control group.Both groups received total intravenous anesthesia.The study group received ketamine combined with propofol,while the control group received ketamine combined with propofol.The agitation score(PAED),pain score(FLACC),extubation time and recovery time,Belinda Infant Development Scale Ⅲ score(BSIDⅢ),mean arterial pressure(MAP),heart rate,body temperature,and adverse reactions were compared between two groups of children during the recovery period.There were 56 cases in the study group and 56 cases in the control group.The PAED score of the study group at 30 minutes(T5)after surgery was(8.20±0.77)points,which was lower than that of the control group(8.59±1.09)points(P<0.05).The FLACC score of the study group at time T 5 was(2.41±0.63)points,which was lower than that of the control group(2.73±0.73)points(P<0.05).The extubation time and awakening time of the study group which were lower than the control group(P<0.05).The BSIDⅢ scores of the study group at 6 and 24 hours after surgery which were higher than those of the control group(P<0.05).The MAP and heart rate at the time points of tracheal intubation(T_(2))and 30 minutes after intubation(T_(3))in the study group were higher than those in the control group(both P<0.05).There was no statistically significant difference in body temperature between the research group and the control group during the four time periods T_(1)~T_(4)(all P>0.05);The incidence of adverse reactions in the research group and control group was 8.92% and 16.07%,respectively,with no statistically significant difference(P>0.05).Conclusion:Compared with ketamine,ketamine combined with propof

关 键 词：艾司氯胺酮 丙泊酚 小儿扁桃体肥大 扁桃体切除术 全身麻醉 

分 类 号：R971[医药卫生—药品]