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河北医学  2022, Vol. 28 Issue (2): 250-254    DOI: 10.3969/j.issn.1006-6233.2022.02.014
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不同剂量丙泊酚对小儿七氟烷麻醉后躁动反应镇静效果和生命特征的影响
赵江河, 吴小乐, 李立, 李筱颖
徐州医科大学附属徐州儿童医院麻醉科, 江苏 徐州 221000
Effect of Different Doses of Propofol on Emergence Agitation, Sedative Effect and Vital Signs of Children After Sevoflurane Anesthesia
ZHAO Jianghe, WU Xiaole, LI Li, et al
Xuzhou Children's Hospital, Xuzhou Medical University, Jiangsu Xuzhou 221000, China
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摘要 目的: 探讨不同剂量丙泊酚对小儿七氟烷麻醉后躁动反应、镇静效果和生命特征的影响。方法: 将本院2018年2月至2020年7月期间收治的173例择期行扁桃体切除术患儿简单随机分为A组、B组、C组三组,分别为55例、60例、58例,三组患儿均给予七氟烷全麻,术后A组静脉注射0.10mL/kg的0.90%氯化钠注射液,B、C组分别静脉注射1.00mg/kg、2.00mg/kg丙泊酚。观察三组患儿术后苏醒情况,及麻醉诱导前(T0)、术后即刻(T1)、拔管即刻(T2)、拔管5min(T3)、拔管10min(T4)生命体征指标变化,记录T2~T4时刻苏醒期躁动评分(PAED)、Ramasay镇静评分(RSS)、儿童疼痛行为量表(FLACC)评分,观察不良反应发生情况。结果: C组患儿PACU滞留时间较其他两组明显缩短(P<0.05),其他指标比较无显著性差异(P>0.05);与T0时刻比较,A组、B组T1、T2、T3时刻的HR、MAP显著上升,C组T1、T2时刻的HR、MAP显著上升(P<0.05);与A组、B组比较,C组T1、T2、T3时刻的HR、MAP显著降低(P<0.05);与T2时刻比较,三组患儿T3、、T4时刻的PAED评分、FLACC评分显著下降,RSS评分均上升(P<0.05),C组T2、T3、、T4时刻的PAED评分、FLACC评分显著低于A、B两组,RSS评分显著高于A、B两组(P<0.05);三组患儿均无呕吐、痉挛、缺氧、窒息等不良反应发生。结论: 七氟烷全身麻醉患儿术后采用静脉注射2.00mg/kg丙泊酚,可有效预防患儿术后躁动反应,维持生命体征稳定,且镇静、镇痛效果明显,安全性高。
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赵江河
吴小乐
李立
李筱颖
关键词 丙泊酚躁动反应镇静效果生命特征不同剂量    
AbstractObjective: To investigate the effect of different doses of propofol on emergence agitation, sedative effect and vital signs of children after sevoflurane anesthesia. Methods: Totally 173 children who underwent elective tonsillectomy in the hospital between February 2018 and July 2020 were randomly divided into group A (n=55), group B (n=60) and group C (n=58). All were given general anesthesia with sevoflurane. Children in group A were injected intravenously with 0.10ml/kg of 0.90% sodium chloride injection, while children in group B and group C were injected intravenously with 1.00mg/kg and 2.00 mg/kg of propofol, respectively. Postoperative recovery and changes in vital signs before induction of anesthesia (T0), immediately after operation (T1), at extubation (T2), 5min after extubation (T3) and 10min after extubation (T4) were observed. The Pediatric Anesthesia Emergence Delirium Scale (PAED) scores, Ramasay sedation scores (RSS) and the Face, Legs, Activity, Cry and Consolability (FLACC) scores at T2~T4 were recorded. Adverse reactions were observed. Results: The length of PACU stay of group C was significantly shorter than that of the other two groups (P<0.05); there were no significant differences in other indicators (P>0.05). Compared with T0, HR and MAP of group A and group B increased significantly at T, T2 and T3. HR and MAP of group C increased significantly at T1 and T2 (P<0.05). Compared with group A and group B, HR and MAP of group C were significantly lower at T1, T2 and T3 (P<0.05). Compared with T2, the PAED scores and FLACC scores of the three groups decreased significantly, and the RSS scores increased at T3 and T4 (P<0.05). The PAED scores and FLACC scores of group C at T2, T3 and T4 were significantly lower than those of group A and group B, and the RSS scoreswere significantly higher than those of group A and group B (P<0.05). No adverse reactions such as vomiting, spasm, hypoxia and asphyxia were observed in the three groups after operation. Conclusion: Intravenous injection of 2.00 mg/kg of propofol after operation can effectively prevent postoperative emergence of agitation and maintain stable vital signs of the children, with obvious sedative and analgesic effects and high safety.
Key wordsPropofol    Emergence agitation    Sedative effect    Vital sign    Different doses
    
基金资助:江苏省徐州市科技项目,(编号:KC16SL123)
通讯作者: 李筱颖   
引用本文:   
赵江河, 吴小乐, 李立, 李筱颖. 不同剂量丙泊酚对小儿七氟烷麻醉后躁动反应镇静效果和生命特征的影响[J]. 河北医学, 2022, 28(2): 250-254.
ZHAO Jianghe, WU Xiaole, LI Li, et al. Effect of Different Doses of Propofol on Emergence Agitation, Sedative Effect and Vital Signs of Children After Sevoflurane Anesthesia. HeBei Med, 2022, 28(2): 250-254.
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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.02.014     或     http://www.hbyxzzs.cn/CN/Y2022/V28/I2/250
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