不同劑量布托啡諾預(yù)防小兒全麻蘇醒期躁動(dòng)的臨床觀察

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1、不同劑量布托啡諾預(yù)防小兒全麻蘇醒期躁動(dòng)的臨床觀(杭州市紅十字會(huì)醫(yī)院浙江杭州310000)【摘要】目的：觀察不同劑量布托啡諾用于預(yù)防學(xué)齡前小兒全麻術(shù)后蘇醒期躁動(dòng)的效果及安全性。方法：選擇3?6歲學(xué)齡前全麻患兒120例，隨機(jī)分為四組.?A、B、C和D四組誘導(dǎo)時(shí)分別靜脈輸注布托啡諾0.5、1、2μg/kg和空白生理鹽水,n=30。觀察血流動(dòng)力學(xué)改變，記錄蘇醒時(shí)間、PACU躁動(dòng)程度、PACU停留時(shí)間、術(shù)后2h、6h鎮(zhèn)靜評(píng)分，同時(shí)觀察術(shù)后呼吸抑制、嗜睡、惡心嘔吐等不良反應(yīng)發(fā)生情況。結(jié)果：A、B、C三組蘇醒期躁動(dòng)發(fā)生率與D組相比有統(tǒng)計(jì)學(xué)差異(P<0.05)；B>C組蘇醒時(shí)間與D組相比有統(tǒng)計(jì)學(xué)差

2、異(P<0.05);B、C組術(shù)中各時(shí)點(diǎn)收縮壓(SBP)、舒張壓(DBP)和心率(HR)與D組相比有統(tǒng)計(jì)學(xué)差異(P<0.05);B、C組PACU停留時(shí)間與D組相比差異有統(tǒng)計(jì)學(xué)意義(P<0.05);B、C組術(shù)后嗜睡發(fā)生率與D組相比差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論：0.5μg/kg布托啡諾能安全、有效地預(yù)防小兒全麻蘇醒期躁動(dòng)，不延長蘇醒時(shí)間和PACU停留時(shí)間，不增加術(shù)后嗜睡的發(fā)生率。【關(guān)鍵詞】布托啡諾；小兒；全麻；蘇醒期躁動(dòng)【中圖分類號(hào)】R614【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1004-6194(2015)02-0368-02ClinicalObservationth

3、eEffectofDifferentButorphanolonEmergenceAgitationafterGeneralAnesthesiainPediatricsZHOUQing(RedCrossHospitalofHangzhou,ZhejiangHangzhou310000,China)【ABSTRACT】ObjectiveToinvestigatetheefficacyandsafetyofdifferentButorphanolonemergenceagitationaftergeneralanesthesiainpreschoolpediatricpatients.Methods

4、120preschoolpediatricpatientsaftergeneralanesthesiaweredividedintofourgroups,with30patientsineachgroup.ThepatientsinGroupA、B、CwereintravenousinjectedButorphanol0.5、1、2μg/kgafterinductionofanesthesia,andpatientsinGroupDwereintravenousinjectednormalsalinesolution.Changesofhemodynamicswererecordedaf

5、terinjection.Theincidenceandthedegreeofemergenceagitation,therecoverytime,thetimeofstayinginPACUand2hor6hObserver'sassessmentofalertness/sedation(OAA/S)scaleafteroperationwererecorded.Theincidenceofadversereactionsuchrespiratorydepression,lethargy,shivering,nauseaandvomitingandsoonwererecorded.Resul

6、tsTheincidenceofemergenceagitationingroupA>B、CweresignificantlylowerthaningroupDaftergeneralanesthesia(P<0.05).SBP、DBPandHRinGroupB、CdecreasedsignificantlycomparedwiththoseinGroupD(P<0.05).TherecoverytimeinGroupB、CweremuchlongerthanthatinGroupD(P<0.05).TheincidenceoflethargyinGroupB>Cwasmuc

7、hmorethaninGroupD(P<0.05).ConclusionItwassafeandfeasibletogiveButorphanol(0.5μg/kg)forreducingemergenceagitationaftergeneralanesthesiainpreschoolpediatricpatients,thetimeofstayinginPACUandrecove