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(P<0.05)。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。
Objective To observe the effect of sevoflurane used in the induction and maintenance of anesthesia on emergency agitation in children undergoing adenotosillectomy, and to explore the relationship between emergence agitation and age. Methods Sixty children, American Society of Anesthesiologists （ASA） grade Ⅰ or Ⅱ, scheduled for adenotonsillectomy were divided into two groups （n = 30） according to their age： preschool age group （3 - 5 years） and school age group （6 - 10 years）. The induction of anesthesia was conducted by inhaling 0.08 sevoflurane, and 5 min later, 0. 1 mg/kg morphine was intravenously administered. Then endotracheal intubation was done. Anesthesia was maintained by adjusting the volume fraction of sevoflurane and continuous intravenous infusion of 0.2μg·kg^-1·min^-1 remifentanil, The time of extubation, time of eye opening, postanesthetic care unit （PACU） stay, incidences of emergence agitation after extubation, eye opening and in PACU were recorded. Results No significant differences were found in the time to extubation or the time to eye opening between two groups （both P〉0. 05）. Compared with school age group, the children in preschool age group had longer staying time in PACU （P〈0.05）. The incidences of emergence agitation were 53.3% after extubation, 36.7% after eye opening, and 63.3% in PACU in the preschool age group, which were significantly higher than those in the preschool age group （26. 7%, 13. 3%, and 33. 3%, respectively, all P〈0. 05）. Conclusion Sevoflurane used in the induction and maintenance of anesthesia will result in a higher incidence of emergence agitation and longer stay time in PACU in preschool age patients as compared with school age patients.
出处
《上海医学》
CAS
CSCD
北大核心
2015年第8期643-646,共4页
Shanghai Medical Journal
基金
2011年度上海市卫生局青年科研资助项目(20114y122)
关键词
吗啡
七氟烷
小儿
扁桃体切除术
苏醒期躁动
Morphine
Sevoflurane
Children
Adenotonsillectomy
Emergency agitation
