两种辅助药物对小儿耳鼻喉手术后躁动的临床研究.docVIP

两种辅助药物对小儿耳鼻喉手术后躁动的临床研究 徐贤惠 孙小英 顾礼萍 徐美云 江苏省扬中市中医院212200 【摘要】 目的 通过两种不同的全身麻醉辅助用药方法，用于小儿耳鼻咽喉科手术，来观察小儿苏醒期躁动的发生率。方法 选择择期接受全身麻醉下行扁桃体和腺样体切除手术共60例，随机分为A、B、C三组。A组:诱导用咪唑安定、丙泊酚、顺阿曲库胺、芬太尼，维持用丙泊酚，间断追加芬太尼。B组：诱导用药同A组，维持用丙泊酚、芬太尼，在手术结束前10分钟静脉注射地左辛。C组：诱导用药同A组，维持用丙泊酚、芬太尼，静脉持续泵入右美托咪定。术后停药每五分钟对患儿进行一次躁动和疼痛评分，结果 PAED评分：A明显高于BC组（P＜0.05);疼痛评分:A明显高于BC组（P＜0.05).结论 右美托咪定和地佐辛可以减少术后躁动的发生。同时m-CHEOPS评分也有一定程度的降低，提示右美托咪定和地佐辛有一定镇痛、镇静作用。 【关键词】 耳鼻咽喉;右美托咪定;地佐辛;躁动;镇痛 Clinical Research on the Effect of Dezocine and Dexmedetomidne in Pediatric Restlessness Patients Undergone Ent Surgery Xu Xianhui Sun Xiaoying Gu Liping Xu Meiyun Anesthesiology Department of Yangzhong City Chinese Medicine Hospital ，Jiangsu Province 212200 【 Abstract 】 Objective: To observe the Effect of Dezocine and Dexmedetomidne in Pediatric Restlessness Patients Undergone Ent Surgery in recovery period. Method:Choose 60 pediatric patients receiving selective general anesthesia surgery to remove the tonsils and adenoids,ASA classification from I to II，aged 4 to 9，weight 16 to 28 Kg.Randomly individ them into A(dexmedetomidine),B(dezocine),C(control) three groups.Anesthesia was induced with midazolam 0.05mg/kg,propofol 2mg/kg,cisatracurium 0.15mg/kg,fentanyl 2ug/kg,and maintaining with propofol 4-6mg/kg?h,remifentanil 0.1-1ug/kg?h.Group A :patients received dexmedetomidine 1ug/kg pumping injection over 10min and followed by a maitenace 0.5ug/kg?h of dexmedetomidine influsion till the end of operation .Group B:dezocine 0.05mg/kg was injected 10 minutes before the end.Group C:the epual volume of NS was pumping injected.The extubation time，the length of stay in the post anesthesia care unit (PACU), agitation and duration when the patients in the PACU were recorded.The degree of EA was assessed by the PAED scale ,pain was m-CHEOPS and sadation measured with Ramsay score when patients once get in the PACU (T0),15min(T1),30min(T2). Results PAED scale: The A group was significantly higher than that in group BC (P