咪达唑仑和丙泊酚对儿童七氟烷麻醉苏醒期躁动的影响

目的：观察咪达唑仑和丙泊酚对儿童七氟烷麻醉苏醒期躁动（EA）的影响。方法：选择120例行先天性斜视矫正手术的患儿，按随机数字表法均分为氯化钠注射液组（S组）、咪达唑仑组（M组）和丙泊酚组（P组）。所有患儿静脉麻醉后，M组给予咪达唑仑0．05mg／kg，静脉注射；P组给予丙泊酚1mg／kg，静脉注射；S组给予0．9％氯化钠注射液2ml，静脉注射。记录3组患儿诱导时间、麻醉维持时间、术中平均动脉压（MAP）、心率（HR）及呼吸频率（RR）；记录3组患儿苏醒和出麻醉后恢复室（PACU）时间及患儿苏醒期躁动（PAED）评分；记录所有患儿镇痛评分（CHIPPs）及EA发生率；观察3组患儿不良反应发生情况。结果：3组患儿术中诱导时间、麻醉维持时间、MAP、HR、RR、苏醒时间、出PACU时间、CHIPPs比较差异均无统计学意义（P〉0．05）。M组患儿和P组患儿EA发生率及PAED评分比较差异无统计学意义（P〉0．05），但较S组患儿EA发生率和PAED评分均显著降低，差异有统计学意义（P〈0．05）。3组患儿治疗期间均未见明显不良反应发生。结论：咪达唑仑和丙泊酚可降低七氟烷麻醉患儿EA发生率和PAED评分，提高患儿复苏质量和安全，且不延长苏醒和出PACU时间，具有较好的临床疗效。

Effects of Midazolam and Propofol on Sevofulrane-induced Emergence Agitation in Children

OBJECTIVE： To observe the effects of midazolam and propofol on emergence agitation （EA） in children who received sevoflurane anesthesia. METHODS： 120 children received orthopia surgery and randomly divided into Sodium chloride injection group （S group）, midazolam group （M group） and propofol group （P group）. After intravenous anesthesia, M group was given midazolam 0.05 mg/kg intravenously; P group was given propofol 1 mg/kg intravenously; S group was given 0.9% Sodium chloride injection 2 ml intravenously. The time of induction, mainttain, MAP, HR and RR were recorded in 3 groups; the time of analepsia and discharging from post anesthetic unit （PACU） were recorded as well as PAED scale. CHIPPs and the incidence of EA were recorded; the occurrence of ADR was observed in 3 groups. RESULTS： There was no statistical significance in time of induction and maintain, MAP, HR, RR, the time of awaking up and discharging from PACU to the ward, CHIPP score among 3 groups （P〉0.05）. There was no statistical significance in the incidence of EA and PAED score between M group and P group （P〉 0.05）; the incidence of EA and PAED score were decreased significantly in S group; there was statistical significance （P〈0.05）. No obvious ADR was found in 3 groups during treatment. CONCLUSIONS： Midazolam and propofol can decrease the incidence of EA and PAED score in children underwent sevoflurane anesthesia, improve the quality and safety of emergence periods and doesn＇ t prolong time of awaking up and discharging from PACU.