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七氟醚麻醉在学龄前期与学龄期儿童扁桃体切除术后苏醒期躁动的比较
Comparison of recovery characteristics in preschool aged children vs school aged children undergoing adenotonsillectomy after anesthesia induction and maintain with sevoflurane
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DOI:
作者:
王珊珊,许文音,卞勇,孙瑛,张马忠
Wang Shanshan, Xu Wenyin, Bian Yong, Sun Ying, Zhang Mazhong
作者单位:
上海交通大学医学院附属上海儿童医学中心麻醉科
Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine
关键词:
吗啡;七氟醚;小儿;扁桃体切除术;苏醒期躁动
Morphine; Sevoflurane; Children; Adenotonsillectomy; Emergency agitation
摘要:
【摘要】 目的 观察七氟醚诱导和维持麻醉在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 60例择期行扁桃体切除术的患儿按年龄分为学龄前期组(3~5岁,n=30)和学龄期组(6~10岁,n=30)。所有患儿均采用8%七氟醚吸入诱导,5min后静注0.1 mg/kg吗啡插入气管内导管。术中调节吸入七氟醚浓度,静脉泵注瑞芬太尼0.2 µgkg-1min-1维持麻醉。记录各组患儿术后拔管时间、睁眼时间、麻醉恢复室(PACU)停留时间、拔管后躁动发生率、睁眼后躁动发生率以及PACU总的躁动发生率。结果 学龄前期组患儿拔管后、睁眼后躁动发生率以及PACU总的躁动发生率明显高于学龄期患儿组(P<0.05),且学龄前期组患儿PACU停留时间明显长于学龄期组。患儿两组患儿拔管时间和睁眼时间无明显差异(P>0.05)。结论 七氟醚诱导和维持麻醉在学龄前期患儿比学龄期患儿更易出现苏醒期躁动,且延长学龄前期患儿的PACU停留时间。 【关键词】吗啡;七氟醚;小儿;扁桃体切除术;苏醒期躁动
Abstract: Objective To observe the recovery characteristics in children undergoing adenotosillectomy after using sevoflurane in induction and maintenance of anesthesia, and investigate the relationship between emergence agitation and age. Methods Sixty children undergoing adenotonsillectomy were divided into Group preschool age (3~5 yrs, n=30) and Group school age (6~10 yrs, n=30). The induction of anesthesia was conducted by 8% sevoflurane, intravenous 0.1 mg/kg morphine was administrated after inhaling sevoflurane for 5 min and then intubation was done. The time to extubation, time to eye opening and time of staying in postanesthetic care unit (PACU) were recorded. Incidences of emergence agitation after extubation and eye opening and total incidence of emergence agitation in PACU were also observed. Results Compared with group school age, patients in group preschool had longer staying time in PACU, higher incidences of emergence agitation after extubation and eye opening and higher total incidence of emergence agitation in PACU. No significant differences were found in time to extubation and time to eye opening between two groups. Conclusion Sevoflurane anesthesia induces emergence agitation more easily and also results in a prolonged stay in PACU in preschool aged patients. Keywords: Morphine; Sevoflurane; Children; Adenotonsillectomy; Emergency agitation
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