等效剂量地佐辛或芬太尼对小儿扁桃体和腺样体手术全麻苏醒期的影响

目的研究对比等效剂量地佐辛或芬太尼对小儿扁桃体和腺样体联合切除术后全麻苏醒期的影响。方法拟行扁桃体和腺样体联合切除的患儿60例,随机分为地佐辛组（D组,n=30）、芬太尼组（F组,n=30）两组。两组患儿均使用丙泊酚、芬太尼、维库溴胺诱导,以丙泊酚、瑞芬太尼维持麻醉。手术开始前,D组患儿静脉注射地佐辛0.1 mg/kg,F组患儿静脉注射芬太尼2.0μg/kg。记录两组患儿手术时间、丙泊酚用量、瑞芬太尼用量和麻醉苏醒期间的情况。结果两组患儿手术时间、丙泊酚用量、瑞芬太尼用量、唤醒时间、拔管时间和麻醉苏醒期镇痛评分无差异性,但地佐辛组麻醉苏醒期清醒评分低于芬太尼组,同时地佐辛组的不良反应少于芬太尼组。结论小儿扁桃体和腺样体联合切除术手术开始前静脉注射地佐辛0.1 mg/kg相比较于芬太尼2.0μg/kg,麻醉和镇痛效果相当,且苏醒质量高,不良反应少。

Effect of equivalent doses of dezocine or fentanyl during recovery period in children with adenotonsillectomy

Objective To compare the effect of equivalent doses of dezocine or fentanyl during recovery period in children with adenotonsillectomy.Methods Sixty cases of children undergoing adenotonsillectomy were randomly assigned into two group;dezocine group（group D,n=30） and fentanyl group（group F,n=30）.The two groups of patients were induced by propofol,fentanyl and vecuronium;propofol and remifentanil was maintained.Just before surgery,the group D of children were given with intravenous injection of dezocine 0.1 mg/kg,group F of children with intravenous fentanyl 2.0 μg/kg.The surgical time,dose of propofol,remifentanil dosage and situation of recovery period were recorded.Results The surgical time,dose of propofol,remifentanil dosage,wake-up time,time to extubation and analgesic score showed no differences between two groups（P＆lt;0.05）,but the Ramsay of group D is lower than group F,and there were fewer adverse reactions in group D.Conclusion Intravenous injection of dezocine 0.1 mg/kg before surgery is more suitable for children with adenotonsillectomy than fentany 2.0 μg/kg,it has exact effect of anesthesia and analgesic、higher level of consciousness awakening and fewer adverse reactions.