摘要
目的 评价不同剂量地佐辛对小儿七氟醚复合麻醉苏醒期躁动的影响。方法 择期行短小手术的患儿100例,年龄1-3岁,随机分为地佐辛0.03mg/kg组（D1组）、0.05mg/kg组（D2组）、0.10mg/kg组（D3组）和对照组,每组25例。患儿面罩吸入6%的七氟醚,睫毛反射消失后静脉给予瑞芬太尼1μg/kg置入喉罩,术中吸入1.5%-2.5%七氟醚,并持续静脉输注瑞芬太尼维持麻醉。在手术开始前D1组、D2组、D3组分别给予地佐辛0.03、0.05和0.10mg/kg,对照组给予等容量生理盐水。记录拔除喉罩时间、麻醉恢复室（PACU）停留时间;PACU期间躁动发生情况,采用患儿麻醉苏醒期躁动量化评分表（PAED）评价躁动程度。患儿入PACU即刻（T0）及15min（T1）、30min（T2）行FLACC评分和Ramsey评分。记录术后24h患儿不良反应的发生情况。结果 与对照组比较,D2组和D3组躁动发生率、PAED评分均明显降低（P〈0.05）;D2组和D3组各时点FLACC评分均明显降低（P〈0.05）,Ramsey评分均明显升高（P〈0.05）。与D2组比较,D3组Ramsey评分明显升高（P〈0.05）。D3组PACU停留时间较其他3组均明显延长（P〈0.05）。结论 0.05mg/kg及0.10mg/kg地佐辛都可以有效减少小儿七氟醚复合麻醉苏醒期躁动的发生,但0.05mg/kg地佐辛可减少七氟醚麻醉后苏醒期躁动且镇静强度适当,不延长PACU停留时间。
Objective To investigate the effect of various doses of dezocine on the prevention of emergence agitation after sevoflurane anesthesia in children. Methods 100 children aged from 1 to 3 years old were randomly divided into 4 groups with 25 cases each：the 0.03 mg/kg dezocine group （group D1）. the 0. 05 mg/kg dezocine group （group D2）, the 0. 10 mg/kg dezocine group （group D3） and the control group. Anaesthesia was induced with 5 % sevoflurane and 1 μg/kg remifentanil. Anaesthesia was maintained with 1.5 %- 2.50% sevoflurane and remifentanil. Different doses of dezocine 0.03 mg/kg,0.05 mg/kg, 0.10 mg/kg, and the same volume saline were administered before surgery. The incidence of emergence agitation was assessed with 5 points scale and the severity of emergence agitation was assessed with Pediatric Anesthesia Emergence Delirium （PAED） scale. The time to remove the laryngeal mask airway, the time to be discharged from the post-anesthesia care unit （PACU）, FLACC and Ramsey scores, post- operative nausea and vomiting were recorded and considered. Results Compared with the control group, the incidence of emergence agitation and PAED scales of DZ and D3 group were significantly lower than it （P〈0. 05）. Compared with the control group, FLACC scores of D2 and D3 group were lower than it（P〈0.05）. At the same time,Ramsey scores of D2 and D3 were higher than that of the control group（P〈0.05）. Moreover,Ramsey score of D3 was higher than D2 （P〈0.05）. The nme span of being discharged from the PACU of D3 was significantly longer than that of the other groups（P〈0.05）. Conclusion Dezocine of 0.05 mg/ kg and 0.10 mg/kg both can reduce the incidence of emergence agitation effectively, and there is no significant difference between the effect of the two doses. However,the dose of 0.05 mg/kg has a better performance in the time span for being discharged from the PACU.
出处
《重庆医学》
CAS
北大核心
2016年第1期74-76,80,共4页
Chongqing medicine
关键词
地佐辛
七氟醚
麻醉恢复期
情绪障碍
儿童
dezocine
sevoflurane
anesthesia recovery period
mood disorders
child
