摘要
目的:研究低剂量盐酸艾司氯胺酮对儿童扁桃体腺样体切除术后苏醒期躁动、疼痛及血流动力学的影响。方法:选取蚌埠医学院第一附属医院2021年12月—2022年8月行扁桃体腺样体切除术的60例患儿,经随机数表法将该60例患儿分为对照组和研究组,各30例。对照组入手术室后静脉滴注0.9%的氯化钠溶液,研究组入手术室后静脉注射0.3 mg/kg的盐酸艾司氯胺酮溶液。两组采取相同的全麻诱导及麻醉维持,术毕停药后即刻将患儿转运至麻醉后监测治疗室(PACU)行全麻复苏。观察两组手术情况、苏醒期躁动程度及疼痛程度、血流动力学指标、不良反应发生率。结果:两组的手术时间、拔管时间、苏醒时间、PACU停留时间比较,差异无统计学意义(P>0.05)。拔管15 min后,研究组的小儿麻醉苏醒期躁动(PAED)评分、疼痛行为量表(FLACC)评分均低于对照组,差异有统计学意义(P<0.05)。拔管时,研究组的平均动脉压(MAP)、心率(HR)均低于对照组,差异有统计学意义(P<0.05)。研究组的不良反应发生率为13.33%,低于对照组的46.67%,差异有统计学意义(P<0.05)。结论:低剂量盐酸艾司氯胺酮应用于儿童扁桃体腺样体切除术,具有较好的麻醉效果,可在维持手术效果的前提下缓解患儿苏醒期躁动程度及疼痛程度,稳定血流动力学指标,降低不良反应发生率。
Objective:To study the effect of low-dose Esketamine Hydrochloride on restlessness,pain,and hemodynamics during recovery period after tonsillectomy and adenoidectomy in children.Method:A total of 60 children who underwent tonsillectomy and adenoidectomy in the First Affiliated Hospital of Bengbu Medical College from December 2021 to August 2022,and the 60 children were divided into control group and study group by random number table method,with 30 cases in each group.The control group was given 0.9%Sodium Chloride Solution intravenously after entering the operating room,and the study group was given 0.3 mg/kg of Esketamine Hydrochloride Solution intravenously after entering the operating room.The two groups took the same general anesthesia induction and anesthesia maintenance,and immediately transferred the children to the postanesthesia care unit(PACU)for general anesthesia resuscitation after drug withdrawal.The operation conditions,restlessness and pain during recovery period,hemodynamic indexes and the incidence of adverse reactions were observed in the two groups.Result:There were no significant differences between the two groups in operation time,extubation time,recovery time and PACU retention time(P>0.05).After 15 minutes of extubation,the pediatric anesthesia emergence delirium(PAED)score and face,legs,activity,cry,consolability(FLACC)score in the study group were lower than those in the control group during the recovery period,and the differences were statistically significant(P<0.05).During extubation,the mean arterial pressure(MAP),heart rate(HR)of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was 13.33%,which was lower than 46.67%in the control group,the difference was statistically significant(P<0.05).Conclusion:The application of low-dose Esketamine Hydrochloride in tonsillectomy and adenoidectomy in children has a good anesthetic effect.It can relieve the degree of restles
作者
沈美君
刘娣
SHEN Meijun;LIU Di(不详;The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《中外医学研究》
2023年第10期11-14,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
中国红十字基金会医学赋能公益专项基金项目(2022451)。
关键词
盐酸艾司氯胺酮
扁桃体腺样体切除术
全麻苏醒期
Esketamine Hydrochloride
Tonsillectomy and adenoidectomy
Recovery period from general anesthesia
