地氟烷在小儿扁桃体腺样体切除术中的应用及对躁动发生情况的影响

目的:探讨地氟烷在小儿扁桃体+腺样体切除术中的应用效果及对全身麻醉苏醒期躁动(EA)的影响。方法:选取2020年3月—2021年3月确诊并治疗的84例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿,按数字表法随机分为对照组和观察组,每组42例。对照组使用七氟烷,观察组使用地氟烷。观察比较两组各时间点指标:手术时间(t_a)、麻醉时间(t_b)、恢复自主呼吸时间(t_c)、出现体动或睁眼时间(t_d)、拔管时间(t_e)、完全清醒时间(t_f)及停留麻醉后恢复室(PACU)时间(t_g);比较两组各个时间点下的小儿麻醉苏醒期躁动量化评分表(PAED)评分;比较两组的不良反应。结果:观察组t_d,t_e,t_f,t_g时间均低于对照组(P<0.05)。观察组拔管时(t₁)、拔管后5 min(t₂)PAED评分低于对照组(P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05),且未发生皮肤瘙痒及呼吸抑制。结论:OSAHS患儿行扁桃体+腺样体切除术中使用地氟烷,可显著降低OSAHS患儿的PAED评分,缩短OSAHS患儿的PACU时间,且安全可靠。

Application of desflurane in children's tonsil and adenoidectomy and its influence on the occurrence of restlessness

Objective:To investigate the application of desflurane in tonsillectomy and adenoidectomy in children and the effect of desflurane on emergence of apparition(EA)during general anesthesia.Methods:A total of 84 children with obstructive sleep apnea hypopnea syndrome(OSAHS)diagnosed and treated in our hospital from March 2020 to March 2021 were selected and randomly divided into two groups(number table method).The control group received sevoflurane and the observation group received desflurane.The relevant time indexes of the two groups were observed and compared:operation time(t_a),anesthesia time(t_b),recovery time of spontaneous breathing(t_c),body movement or eye opening(t_d),extubation(t_e),full consciousness(t_f),and recovery room(PACU)time(t_g)levels and their differences.The level and difference of pediatric anesthesia emergence delirium scale(PAED)score between the two groups ateach time point.Adverse reactions in two groups.Results:The t_d,t_e,t_fand t_gin the observation group were significantly lower than those in the control group(P<0.05).The PAED score of the observation group was significantly lower than that of the control group after extubation(t₁)and 5 min after extubation(t₂)(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).No skin pruritus and respiratory depression occurred.Conclusion:The use of desflurane in tonsillectomy and adenoidectomy in children with OSAHS can significantly reduce the PAED score and shorten the PACU time in children with OSAHS,and it is safe and reliable.