艾司氯胺酮不同给药方式对尿道下裂术后患儿苏醒期躁动的影响  

The impact of different administration methods of esketamine on agitation during recovery in pediatric patients after hypospadias surgery

作　　者：李海锟 高国君 毛栋栋 程杰 陈冬冬 LI Haikun;GAO Guojun;MAO Dongdong;CHENG Jie;CHEN Dongdong(Department of Urology Surgery,Affiliated Hospital of Shandong Second Medical University,Weifang 261031,China;Department of Anesthesiology,Affliated Hospital of Shandong Second Medical University)

机构地区：[1]山东第二医科大学附属医院泌尿外科,山东潍坊261031 [2]山东第二医科大学附属医院麻醉科

出　　处：《山东第二医科大学学报》2025年第1期61-64,共4页Journal of Shandong Second Medical University

基　　金：山东省学校卫生协会心理健康与精神卫生研究专项课题(项目编号:XLZX2024047)。

摘　　要：目的 探讨艾司氯胺酮不同给药方式用于超声下骶麻(SA)对尿道下裂成形术后患儿苏醒期躁动的影响。方法 选取2022年1月~2024年7月于山东第二医科大学附属医院泌尿外科行尿道下裂成形术的患儿120例,随机分为E-S组(SA给予艾司氯胺酮0.5 mg/kg)、E-V组(静推艾司氯胺酮0.5 mg/kg)和对照组,每组40例。比较3组手术时间、出血量及输液量;比较3组患儿苏醒时间、恢复室停留时间、PAED评分、FLACC评分、术中丙泊酚使用量;比较并观察不良反应发生情况、父母满意度。结果 在苏醒时间、恢复室停留时间方面,3组差异无统计学意义(P>0.05);3组术后躁动PAED评分及FLACC评分和术中丙泊酚用量、父母满意度差异均有统计学意义(P<0.05)。与对照组比较,E-S组和E-V组PAED评分、FLACC评分、术中丙泊酚使用量均明显降低,父母满意度明显增加(P<0.05),其中E-S组PAED评分、FLACC评分明显低于E-V组(P<0.05),E-S组和E-V组术中丙泊酚使用量、父母满意度无明显差异(P>0.05)。3组手术时间、出血量及输液量比较,差异均无统计学意义(P>0.05)。3组均未发生其他严重不良反应。结论 0.5 mg/kg艾司氯胺酮通过静脉注射或骶管给药均能减少小儿苏醒期躁动现象,提升父母满意度。特别是骶管给药,延长术后镇痛持续时间的同时并未增加不良反应,可加速儿童术后身心恢复。Objective To investigate the effects of different administration methods of esketamine used in conjunction with ultrasound-guided sacral anesthesia(SA)on agitation during the recovery phase in pediatric patients af-ter hypospadias repair surgery.Methods A total of 120 pediatric patients scheduled for hypospadias repair surgery at the Urology Department of the Affiliated Hospital of Shandong Second Medical University from January 2022 to January 2024 were randomly assigned to three groups:E-S group(receiving esketamine 0.5 mg/kg via SA),E-V group(receiving esketamine 0.5 mg/kg intravenously),and control group with 40 participants in each group.The operative time,bleeding volume,and fluid administration were compared among the three groups.Furthermore,time to recovery,duration of stay in the recovery room,PAED score,FLACC score and intraoperative usage of propofol were assessed and compared.Adverse reactions and parental satisfaction were also recorded and evaluated.Results There was no statistically significant differ-ence in terms of recovery time and duration of stay in the recovery room among the three groups(P>0.05).However,sta-tistically significant differences were observed in postoperative agitation PAED scores,FLACC scores,intraoperative propofol consumption and parental satisfaction(P<0.05).Compared to the control group,both the E-S and E-V groups exhibited significantly reduced PAED and FLACC scores,lower intraoperative propofol usage and enhanced parental sat-isfaction(P<0.05).Specifically,PAED and FLACC scores of E-S group were significantly lower than E-V group(P<0.05),while there were no significant differences in intraoperative propofol consumption and parental satisfaction between E-S and E-V groups(P>0.05).There were no statistically significant differences in terms of operative time,bleeding vol-ume and fluid administration among the three groups(P>0.05).No severe adverse reactions were reported in any group.Conclusion Administration of esketamine at a dose of 0.5 mg/kg,whether via intravenous in

关 键 词：艾司氯胺酮 给药方式 骶麻 尿道下裂成形术 术后苏醒期躁动 

分 类 号：R614.2[医药卫生—麻醉学]