丙泊酚预防扁桃体腺样体切除术患儿七氟醚麻醉后躁动的效果

摘要

目的：探讨静脉注射丙泊酚预防扁桃体和（或）腺样体切除术患儿七氟醚麻醉后躁动（ EA）的效果。方法择期行扁桃体和（或）腺样体切除术患儿60例，随机分为P1、P2及C组，每组20例。3组患儿在手术结束时分别静脉推注1 mg／kg丙泊酚（10 s）、2 mg／kg丙泊酚（20 s）及5 ml生理盐水（10 s），观察3组患儿拔管时（T1）、拔管后10 min（T2）、拔管后20 min（T3）及拔管后30 min（T4）的各项生命体征及PAED评分，记录改良Aldrete评分（到达苏醒室即刻）、疼痛评分（FLACC评分）、拔管时间及苏醒室停留时间。结果与C组相比，P1组、P2组患儿T1、T2、T3的PAED评分均明显降低（P＜0．05）；与P1组比较，P2组患儿T1、T2、T3的PAED评分明显降低（P＜0．05）。3组患儿躁动发生率分别为32．4％、21．7％及41．9％，差异有统计学意义（P＜0．05）。与C组相比，P1组和P2组患儿拔管时间明显延长（P＜0．05）；与P1组比较，P2组患儿拔管时间明显延长（P＜0．05）。3组患儿改良Aldrete评分、FLACC评分、苏醒室停留时间及生命体征比较，差异无统计学意义（P＞0．05）。结论采用2 mg／kg 丙泊酚静脉注射（20 s）预防七氟醚麻醉后躁动反应安全有效，具有临床参考价值。%Objective To assess the preventive effects of propofol on the emergence agitation ( EA) of child patients under sevoflurane anesthesia during tonsillectomy and/or adenotonsillectomy.Methods A total of 60 patients undergo-ing tonsillectomy and/or adenotonsillectomy were randomized into three groups ( n=20):Group P1 , Group P2 and Group C, which were intravenously infused with 1 mg/kg of propofol (10 s), 2 mg/kg of propofol (20 s) and 5 ml of normal saline (10 s) before the end of operation, respectively.The three groups were compared for vital signs and PAED score immediately after and 10, 20, 30 min after extubation (T1, T2, T3 and T4).The modified Aldrete score, pain score ( FLACC score) , extubation time and recovery time were also recorded.Results Compared with Group C, Groups P1 and P2 showed reduced PAED score at T1, T2 and T3(P<0.05).Compared with Group P1, the PAED score was re-markably lower in Group P2 at T1, T2 and T3(P<0.05).The incidence of EA was 32.4% for Group P1, 21.7% for Group P2 and 41.9%for Group C, which were significantly different (P<0.05).Compared with Group C, the extuba-tion time was obviously extended in Groups P1 and P2 (P<0.05).Compared with Group P1, the extubation time was markedly longer in Group P2 (P<0.05).There were no significant difference in the modified Aldrete score, FLACC score, recovery time and vital signs between Groups P1 and P2 ( P>0.05) .Conclusions Intravenous injection of 2 mg/kg propofol over 20 s can effectively prevent EA in child patients under sevoflurane anesthesia.