舒芬太尼预防小儿七氟醚全麻苏醒期躁动的临床研究

摘要

Objective:To evaluate the effects of small dose of sufentanil and fentanyl on emergence agitation in paediatric patients undergoing sevoflurane anesthesia to understand the prevention effect of sufentanil on emergence agitation of preschool children. Methods:80 preschool children undergoing sevoflurane anesthesia for repair of unilateral inguinal hernia were random-ly divided into the group of sufentanil(group S,n = 40)and the group of fentanyl(group F,n = 40). 0. 15 μg/ kg of sufentanil was given(iv)to group S and 1. 5 μg/ kg of fentanyl to group F just before skin incision. Such related data were kept down and analyzed as the score of emergence agitation scale,the number of paediatric patients receiving additional fentanyl during surgery, the time for emergence,the time for staying at postanesthesia care unit(PACU)and perioperative adverse effects. Results:The scores of emergence agitation scale and the frequency of severe emergence agitation were significantly lower in group S than those in group F. There were markedly fewer paediatric patients in group S requiring additional fentanyl during and after surgery than in group F. The incidence of vomiting was significantly lower in group S than that in group F. Conclusion:Compared with fentanyl, sufentanil intravenously injected can remarkably decrease the incidence of emergence agitation in preschool children with general sevoflurane anaesthesia,without notable effect on emergence .%目的：研究小剂量舒芬太尼及芬太尼对小儿七氟醚全麻术后苏醒期躁动的影响，了解舒芬太尼防治小儿七氟醚全麻后苏醒期躁动的效果及安全性。方法：80例行腹股沟斜疝手术的患儿，随机分为舒芬太尼（ S）组、芬太尼（F）组，每组40例，分别在切皮前静脉注射舒芬太尼0.15μg/ kg 或1.5μg/ kg 芬太尼。观察患儿苏醒期躁动评分、围术期芬太尼追加量、麻醉苏醒时间、PACU 停留时间及围手术期不良反应发生情况。结果：S 组患儿苏醒期躁动评分及术后严重躁动发生率明显低于 F 组，S 组需术中追加芬太尼及术后追加芬太尼的患儿明显少于 F 组，S 组患儿恶心呕吐发生率明显低于 F 组。结论：与芬太尼相比，静脉注射舒芬太尼可明显降低小儿七氟醚全麻苏醒期躁动发生率，对麻醉苏醒无明显影响。