纳美芬在小儿腺样体扁桃体切除术中的应用

摘要

目的：观察纳美芬在小儿腺样体扁桃体切除术中的应用效果。方法：60例需行腺样体扁桃体切除术的患儿，ASAⅠ或Ⅱ级，年龄3～7岁，随机均分为纳美芬组（A组），生理盐水对照组（B组）。A组术毕时接受0.25µg/kg纳美芬，B组则给予相同容量的生理盐水。记录两组患儿入室时（T1）,术毕时（T2），自主呼吸恢复时（T3），拔管时（T4），拔管后2分钟（T5）的HR，MAP，并记录手术时间，术毕至拔管时间，拔管后不良事件，拔管后2分钟的FLACC评分值。结果：A组拔管时间短于B组（P＜0.05），A组T4、T5时HR快于B组（P＜0.05），以上差异均有统计学意义。两组患儿术后FLACC评分差异无统计学意义（P＞0.05）。B组拔管后有3例(10%)出现SPO2下降至85%以下,其中1例（3%）进展为重度喉痉挛,A组未发生类似不良反应。结论：纳美芬在小儿腺样体扁桃体切除术中应用，能够缩短拔管时间，减少不良事件，并且没有增加术后疼痛。%[ABSTRACT]Objective: To evaluate the effect of Nalmefene infusion in pediatric patients receiving adenotonsillectomy. Methods:Sixty patients (3~7, ASAⅠor Ⅱ or) underwent adenotonsillectomy were randomly divided into two groups, group A and B. Patients in group A received 0.25µg/kgNalmefene infusion and patients in group B received saline of equivalent capacity at the end of operation. HR and MAP were observed on arrival (T1), the end of operation (T2) and respiratory recovery (T3), extubation (T4), 2 min after extubation (T5). Operation time,extubation time, adverse reactions and postoperative FLACC scale in two min were recorded respectively. Results: Extubation time was shorter and HR was higher at T4-T5 in group A(P<0.05). There were no significant different in FLACC scale between two groups(P>0.05). In group B,3 patients’ SPO2 were under 85% after extubation, and one of them developed serious laryngospasm. There were no similar side effects in group A. Conclusion:Nalmefene infusion in pediatric adenotonsillectomy can shorten extubation time and reduce adverse reaction. Nalmefene does not enhance postoperative pain.