摘要
目的评价咪达唑仑术前用药预防短小手术患儿七氟醚麻醉恢复期躁动（EA）的效果。方法择期扁桃体联合腺样体切除术患儿120例，性别不限，年龄3～9岁，体重15～35kg，ASA分级I或Ⅱ级，采用随机数字表法，将其分为4组（n=30），麻醉前30min，对照组（C组）口服10％葡萄糖10ml，不同剂量咪达唑仑组（M1-3组）分别口服0．25、0．50和0．75mg／kg咪达唑仑与10％葡萄糖混合液10ml。吸入七氟醚麻醉诱导，静脉输注瑞芬太尼和吸入七氟醚维持麻醉。采用患儿麻醉恢复期躁动量化评分表（PAED）评价患儿EA的发生情况。结果与C组比较，M2组和M3组PAED评分及EA发生率降低（P〈0．05），M1组差异无统计学意义（P〉0．05）；与M1组比较，M2组和M3组PAED评分及EA发生率降低（P〈0．05）；与M2组比较，M3组PAED评分及EA发生率差异无统计学意义（P〉0．05）。结论口服咪达唑仑术前用药可预防患儿短小手术七氟醚麻醉恢复期躁动，其适宜剂量为0．50mg／kg。
Objective To evaluate the efficacy agitation （EA） after sevoflurane anesthesia in children of midazolam premedication for prevention of emergence undergoing minor surgery. Methods One hundred and twenty ASA physical status I or II paediatric patients, aged 3-9 yr, weighing 15-35 kg, scheduled for elective tonsillectomy and adenoidectomy, were randomly divided into 4 groups （ n = 30 each） ： control group （group C ） and midazolam 0.25, 0.50 and 0.75 mg/kg groups （groups MI 3 ）. The 10 ml mixture of midazolam 0.25, 0.50 and 0.75 mg/kg and 10% glucose was taken orally at 30 min before anesthesia in M1-3 groups, respectively, while 10 ml of 10% glucose was taken orally in group C. Anesthesia was induced with inhalation of sevoflurane and maintained with iv infusion of remifentanil and inhalation of sevoflurane. EA was assessed using the Pediatric Anesthesia Emergence Delirium （PAED） scale. Results Compared with group C, the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 （P 〈 0.05 ） , and no significant change was found in group M1 （P 〉 0.05）. Compared with group M1, the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 （ P 〈 0.05 ） . There was no significant difference in the PAED scores and incidence of EA between groups M3 and M2 （ P 〉 0.05 ）. Conclusion Premedication with oral midazolam can prevent EA following sevoflurane anesthesia in children undergoing minor surgery and the optimum dose is 0.50 mg/kg.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2013年第5期541-543,共3页
Chinese Journal of Anesthesiology
关键词
剂量效应关系
药物
术前用药法
咪达唑仑
情绪障碍
麻醉药
吸入
儿童
Dose-response relationship, drug
Premedication
Midazolam
Mood disorders
Anesthetics, inhalation
Child
