【摘要】：目的觀察七氟烷誘導(dǎo)和維持麻醉下行扁桃體切除術(shù)患兒術(shù)后蘇醒期躁動的情況,探討躁動發(fā)生率與年齡的關(guān)系。方法選擇美國麻醉醫(yī)師協(xié)會分級Ⅰ和Ⅱ級,擇期行扁桃體切除術(shù)的患兒共60例,按年齡分為學(xué)齡前期組(3~5歲)和學(xué)齡期組(6~10歲),每組30例。所有患兒均吸入體積分數(shù)為0.08的七氟烷行麻醉誘導(dǎo),5min后靜脈注射0.1mg/kg嗎啡,插入氣管內(nèi)導(dǎo)管。術(shù)中調(diào)節(jié)吸入七氟烷體積分數(shù),經(jīng)靜脈泵注射瑞芬太尼0.2μg·kg~(-1)·min~(-1)維持麻醉。記錄各組患兒術(shù)后拔除氣管導(dǎo)管的時間(拔管時間)、睜眼時間、麻醉后恢復(fù)室(PACU)停留時間,以及拔除氣管導(dǎo)管后、睜眼后和在PACU的總體躁動發(fā)生率。結(jié)果兩組間患兒術(shù)后拔管時間、睜眼時間的差異無統(tǒng)計學(xué)意義(P值均0.05),但學(xué)齡前期組患兒的PACU停留時間顯著長于學(xué)齡期組(P0.05)。學(xué)齡前期組患兒拔除氣管導(dǎo)管后、睜眼后和在PACU的總體躁動發(fā)生率分別為53.3%、36.7%、63.3%,均顯著高于學(xué)齡期組的26.7%、13.3%、33.3%(P值均0.05)。結(jié)論七氟烷誘導(dǎo)和維持麻醉用于學(xué)齡前期患兒比學(xué)齡期患兒更易發(fā)生蘇醒期躁動,且延長學(xué)齡前期患兒的PACU停留時間。
[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.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬上海兒童醫(yī)學(xué)中心麻醉科;
【基金】：2011年度上海市衛(wèi)生局青年科研資助項目(20114y122)
【分類號】：R726.1

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