静脉持续输注利多卡因对小儿七氟醚麻醉后苏醒期躁动的影响

目的观察持续静脉输注利多卡因对小儿七氟醚麻醉后苏醒期躁动的影响。方法选择60例择期行扁桃体和(或)腺样体摘除术患儿,随机分为L组和S组,每组30例。L组在气管插管前缓慢静推利多卡因1.5 mg.kg-1,并以2 mg.kg-1.h-1的速度持续泵注至术毕,S组则静脉给予等量生理盐水。两组患儿术中均用七氟醚吸入维持麻醉。记录患儿麻醉前(T0)和拔管时(T1)的MAP和HR、手术时间、拔管时间、PACU留观时间,拔管后行苏醒期躁动(Pediatric Anesthesia Emergence Deliri-um,PAED)评分。结果两组患儿术后拔管时间和PACU留观时间近似;与S组比较,L组拔管时MAP、HR明显降低(P0.05),苏醒期PAED评分与躁动发生率均较低(P0.05)。结论持续静注利多卡因可以降低小儿七氟醚麻醉后拔管期间的心血管反应,减少苏醒期躁动的发生。

Effect of continuous intravenous infusion of lidocaine on emergence agitation after sevoflurane inhaled anesthesia in children

Objective To observe the effect of continuous intravenous infusion of lidocaine on emergence agitation after sevoflurane inhaled anesthesia in children.Methods Sixty children selected for adenotonsillectomy were randomly divided into 2 groups(n=30):group L and group S.In group L,1.5 mg·kg-1 lidocaine was injected before tracheal intubation,then 2 mg·kg-1·h-1 IV intraoperatively.In group S,the same volume of saline was given.In 2 groups,anesthesia were maintained with inhaled sevoflurane.The MAP and HR before induction(T0)and during extubation(T1),operation time,extubation time and time spent in PACU were recorded.After extubation,the pediatric anesthesia emergence delirium(PAED) scale was evaluated.Results There were no significant differences in time of extubation and time spent in PACU.Compared to group S,the MAP and HR were significantly decreased during extubation in group L(P<0.05).The PAED scores and incidence of EA were lower in group L than those in group S(P<0.05).Conclusion Continuous intravenous infusion of lidocaine can reduce the cardiovascular reaction due to extubation and the incidence of EA after sevoflurane anesthesia in children.