[1]刁云霞,孙晓妮,李思远.麻醉诱导期不同剂量舒芬太尼在儿童扁桃体摘除术中的应用效果及安全性观察[J].陕西医学杂志,2022,51(6):692-696.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.012]
　DIAO Yunxia,SUN Xiaoni,LI Siyuan.Application effect and safety of different doses of sufentanil during anesthesia induction in children undergoing tonsillectomy[J].,2022,51(6):692-696.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.012]
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麻醉诱导期不同剂量舒芬太尼在儿童扁桃体摘除术中的应用效果及安全性观察
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年6期
页码:
692-696
栏目:
临床研究
出版日期:
2022-06-05

文章信息/Info

Title:
Application effect and safety of different doses of sufentanil during anesthesia induction in children undergoing tonsillectomy
作者:
刁云霞1; 2; 孙晓妮2; 李思远1
(1.西安交通大学第二附属医院麻醉科,陕西 西安 710004; 2.咸阳彩虹医院麻醉科,陕西 咸阳 712021)
Author(s):
DIAO Yunxia; SUN Xiaoni; LI Siyuan
(Department of Anesthesiology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
关键词:
舒芬太尼;  麻醉诱导;  扁桃体摘除术;  剂量;  应用效果;  安全性
Keywords:
Sufentanil;  Anesthesia induction;  Tonsillectomy;  Dose;  Application effect;  Safety
分类号:
R 762
DOI:
DOI:10.3969/j.issn.1000-7377.2022.06.012
文献标志码:
A
摘要:
目的:探究麻醉诱导期不同剂量舒芬太尼在儿童扁桃体摘除术中的应用效果及安全性。方法:选取行全麻下扁桃体摘除术的患儿105例为研究对象,采用简单随机法分为低剂量组(34例)、中剂量组(35例)和高剂量组(36例),麻醉诱导时分别静脉注射0.2、0.3、0.4 μg/kg舒芬太尼,术中均采用2.0%～4.0%七氟烷维持麻醉。比较三组患儿麻醉诱导前(T0)、插管前(T1)、插管后10 min(T2)、手术结束时(T3)、拔管后10 min(T4)的血流动力学指标、麻醉效果、术后镇痛及镇静效果、苏醒质量及苏醒期躁动情况。结果:三组患儿不同时间点心率(HR)、平均动脉压(MAP)比较差异有统计学意义(均P<0.05)。随着剂量增加,麻醉诱导时间依次缩短,自主呼吸恢复时间、拔管时间、苏醒时间及定向力恢复时间依次延长,且各组间比较差异有统计学意义(均P<0.05)。随着时间推移,三组视觉模拟量表(VAS)评分均依次递增,Ramsay镇静评分依次递减,组内各时间点比较差异有统计学意义(均P<0.05); 拔管后10 min,三组患儿VAS评分、Ramsay评分比较差异无统计学意义(均P>0.05); 术后1、3 h,三组患儿VAS评分、Ramsay评分比较差异有统计学意义(均P<0.05)。三组患儿苏醒质量比较差异无统计学意义(P>0.05)。三组患儿苏醒期烦躁量表(PAED)评分、躁动发生情况比较差异有统计学意义(均P<0.05)。三组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论:0.3～0.4 μg/kg舒芬太尼复合七氟烷麻醉用于小儿扁桃体摘除术,麻醉稳定性好,镇痛、镇静效果明显,术后苏醒期躁动发生率低,安全性较高。
Abstract:
Objective:To explore the application effect and safety of different doses of sufentanil during anesthesia induction in children undergoing tonsillectomy.Methods:A total of 105 children who underwent tonsillectomy under general anesthesia were selected as the research objects,and were divided into low-dose group(34 cases),medium-dose group(35 cases)and high-dose group(36 cases)by simple randomization.During induction,the three groups were injected intravenously with 0.2,0.3 and 0.4 μg/kg of sufentanil respectively,and 2.0% to 4.0% sevoflurane was used to maintain anesthesia during the operation.The hemodynamic indexes before anesthesia induction(T0),before intubation(T1),10 minutes after intubation(T2),at the end of surgery(T3),and 10 minutes after extubation(T4)were compared among the three groups.The anesthesia effect,postoperative sedation pain and sedative effects,recovery quality and agitation during recovery were compared among the three groups.Results:There were statistically significant differences in heart rate(HR)and mean arterial pressure(MAP)between the three groups at different time points(all P<0.05).With the increase of the dose,the induction time of anesthesia was shortened in turn,and the recovery time of spontaneous breathing,extubation,recovery time and orientation recovery time were successively prolonged,and there were significant differences among the groups(all P<0.05).With the passage of time,the VAS scores of the three groups increased in turn,and the Ramsay sedation scores decreased in turn,and the differences were statistically significant at each time point among three groups(all P<0.05); there were no significant differences in VAS scores and Ramsay scores among the three groups(all P>0.05); 1 and 3 hours after operation,there were statistically significant differences in VAS scores and Ramsay scores among the three groups(all P<0.05).There was no significant difference in the quality of recovery among the three groups(P>0.05).There were significant differences in PAED score and agitation occurrence among the three groups(all P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:Sufentanil 0.3-0.4 μg/kg combined with sevoflurane anesthesia for pediatric tonsillectomy has good anesthetic stability,obvious analgesic and sedative effects,low incidence of agitation during postoperative recovery period,and high safety.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2018SF-265)
更新日期/Last Update: 2022-06-06