七氟烷麻醉用于学龄前期与学龄期患儿扁桃体切除术后苏醒期躁动的比较

发布时间：2018-12-15 15:57

【摘要】：目的观察七氟烷诱导和维持麻醉下行扁桃体切除术患儿术后苏醒期躁动的情况,探讨躁动发生率与年龄的关系。方法选择美国麻醉医师协会分级Ⅰ和Ⅱ级,择期行扁桃体切除术的患儿共60例,按年龄分为学龄前期组(3~5岁)和学龄期组(6~10岁),每组30例。所有患儿均吸入体积分数为0.08的七氟烷行麻醉诱导,5min后静脉注射0.1mg/kg吗啡,插入气管内导管。术中调节吸入七氟烷体积分数,经静脉泵注射瑞芬太尼0.2μg·kg~(-1)·min~(-1)维持麻醉。记录各组患儿术后拔除气管导管的时间(拔管时间)、睁眼时间、麻醉后恢复室(PACU)停留时间,以及拔除气管导管后、睁眼后和在PACU的总体躁动发生率。结果两组间患儿术后拔管时间、睁眼时间的差异无统计学意义(P值均0.05),但学龄前期组患儿的PACU停留时间显著长于学龄期组(P0.05)。学龄前期组患儿拔除气管导管后、睁眼后和在PACU的总体躁动发生率分别为53.3%、36.7%、63.3%,均显著高于学龄期组的26.7%、13.3%、33.3%(P值均0.05)。结论七氟烷诱导和维持麻醉用于学龄前期患儿比学龄期患儿更易发生苏醒期躁动,且延长学龄前期患儿的PACU停留时间。
[Abstract]:Objective to observe the restlessness during postoperative recovery in children undergoing tonsillectomy under sevoflurane induction and maintenance, and to explore the relationship between the incidence of restlessness and age. Methods A total of 60 children with selective tonsillectomy were divided into pre-school group (3 ~ 5 years old) and school-age group (6 ~ 10 years old) with 30 cases in each group. All children were induced by sevoflurane with volume fraction 0.08. 0.1mg/kg morphine was injected intravenously after 5min and inserted into trachea catheter. The volume fraction of sevoflurane inhaled was adjusted and remifentanil 0.2 渭 g kg~ (-1) min~ (-1) was injected intravenously to maintain anesthesia. The time of extubation (extubation time), the time of eye opening, the time of (PACU) stay in the recovery chamber after anesthesia, the total restlessness rate after extubation of trachea catheter and in PACU were recorded. Results there was no significant difference in extubation time and eye opening time between the two groups (P < 0. 05), but the PACU residence time in the preschool group was significantly longer than that in the school age group (P0.05). After trachea catheter was removed, the total restlessness rate after opening eyes and in PACU in preschool group was 53.3% and 36.7%, respectively, which was significantly higher than that in school age group (26.7g / 13.3), which was significantly higher than that in school-age group (26.7g / 13.3). 33.3% (P < 0.05). Conclusion sevoflurane induced and maintained anesthesia is more likely to occur restlessness in recovery period and prolong PACU residence time in preschool children than in school-age children.
【作者单位】：上海交通大学医学院附属上海儿童医学中心麻醉科;
【基金】：2011年度上海市卫生局青年科研资助项目(20114y122)
【分类号】：R726.1

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