舒芬太尼减轻小儿全麻苏醒期躁动的临床观察

目的观察舒芬太尼对比芬太尼用于小儿七氟烷全麻下斜视矫正术后苏醒期躁动的效果及安全性。方法选择择期行斜视矫正手术的患儿80例,随机分为两组:芬太尼组(F组,n=40)和舒芬太尼组(S组,n=40),分别复合七氟烷行全身麻醉,手术结束拔管后送PACU继续观察,直至送回病房。记录麻醉时间、手术时间、拔管时间及恢复时间;以及入室时、喉罩置入前及置人后1 min 3个时间点的平均动脉压(MAP),心率和血氧饱和度(SpO2);记录患儿全麻苏醒期重度躁动发生率,麻醉后苏醒期躁动评分以及每组在PACU需要使用丙泊酚镇静例数;随访患儿术后有元出血、恶心、呕吐等不良反应发生。结果两组全麻维持时间、手术时间、拔管时间、PACU恢复时间以及各时间点生命体征变化均无统计学意义;PAED评分及术后重度躁动的发生率:S组低于F组,差异有统计学意义;在需要镇静例数及术后并发症方面,两组差异无统计学意义。结论七氟烷吸入麻醉下行斜视矫正术的小儿,全麻诱导期给予舒芬太尼0.2μg/kg较等效剂量的芬太尼(2μg/kg),更能减少麻醉后苏醒期躁动的发生,且不延长苏醒和拔管时间以及出PACU时间,不增加术后出血、恶心、呕吐的发生率。

Clinical observation of reducing pediatric emergence agitation by sulfentanyl combined with sevoflurane general anaesthesia

Objetive To obersve the therapeutic efficacy and safety of sulfentanyl contrasting fentanyl in emergence agitation of pediatric strabismus operation by sevoflurane general anaesthesia. Methods Select e-lective strabismus operation in 80 cases.Randomly divided into sulfentanyl group(F n =40)and fentanyl group (S n =40),using sevoflurane to general anaesthesia.Postoperative extubation and obersvation when achieve ex-tubation indication.Then returned to the wards.Recording the time of anesthesia,operation,extubation,recovery and the MAP of the three time point:entering the operation room,laryngeal mask placement before and laryngeal mask placement 1 minutes after.Recording the incidence of severe agitation,PAED scores and the cases of propofol injection in PACU.Follow-up of postoperative patients with adverse reaction such as bleeding,nausea, vomiting. Results The 2 groups of childrens with PAED scores and the incidence of postoperative severe agi-tation had statistical significance.S group lower than F group.while the time of anesthesia,operation,extubation recovery and each time point changes of vital signs had no statistical significance.The cases of propofol injection in PACU also had no statistical significance. Conclusions In the induction period of sevoflurane general an-esthesia of strabismus surgery in children,sulfentanyl0.2 μg/kg compared with the equivalent dose fentanyl 2μg/kg,can reduce the incidence of emergence agitation,and does not prolong the emergence and extubation time and PACU residence time,does not increase the incidence of postoperative bleeding,nausea and vomiting.