中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (1): 40-44.doi: 10.19438/j.cjoms.2021.01.008

• 论著 • 上一篇    下一篇

喷他佐辛预防儿童腭裂手术全麻苏醒期躁动的效果评价

张凌, 仇琳*, 纪均*   

  1. 上海交通大学医学院附属第九人民医院 麻醉科,上海 200011
  • 收稿日期:2020-03-19 修回日期:2020-06-09 出版日期:2021-01-20 发布日期:2021-02-19
  • 通讯作者: 仇琳,E-mail: jolin_ql@163.com;纪均,E-mail: lordjjun@163.com。*共同通信作者
  • 作者简介:张凌（1978-）,女,硕士,主治医师,E-mail：zhangling_zl78@126.com

Use of pentazocine to prevent agitation in children with cleft palate surgery during the recovery period of general anesthesia

ZHANG Ling, QIU Lin, JI Jun   

  1. Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2020-03-19 Revised:2020-06-09 Online:2021-01-20 Published:2021-02-19

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摘要： 目的: 探讨喷他佐辛对减轻儿童腭裂修复手术全身麻醉苏醒期躁动的作用及安全性。方法: 选择ASAⅠ~Ⅱ级、年龄1~3岁,符合入选标准的择期全麻下行腭裂修复手术的患儿60例,随机分为3组,即P1组、P2组和NS组,每组20例。在进入麻醉后恢复室（post-anesthetic care unit,PACU）即刻,分别静注喷他佐辛 0.5 mg/kg（P1组）、0.3 mg/kg（P2组）和0.9% NaCl（NS组）。比较3组患儿在苏醒期间的呛咳评分、Ramsay镇静评分、儿童全麻躁动评分（PAED）和儿童疼痛评分（m-CHEOPS）;观察各时间点HR、MBP、RR、SPO2的变化和不良事件发生率。采用SPSS 19.0软件包进行数据处理。结果: P1和P2组在苏醒期间Ramsay镇静评分显著高于NS组（P<0.05）;呛咳评分显著低于NS组（P<0.05）;P1组的PAED评分和m-CHEOPS评分显著低于NS组（P<0.01）,P2组低于NS组,但无统计学意义（P>0.05）。3组患儿转出麻醉恢复室时间以及不良事件发生率的差异无统计学意义(P>0.05)。结论: 术后注射0.5 mg/kg喷他佐辛,可有效降低腭裂患儿苏醒期躁动发生率,使患儿在苏醒期间更加平稳安全。

关键词: 喷他佐辛, 腭裂, 苏醒期躁动, 儿童, 全麻

Abstract: PURPOSE: To investigate the effect and safety of pentazocine to relieve the emergence agitation on children, who received cleft palate surgery during the recovery period of general anesthesia. METHODS: Sixty children, ASA I~II,aged 1-3 years old who received cleft palate surgery, were randomly divided into 3 groups(n=20): group P1, group P2 and group NS. When entering the post-anesthetic care unit (PACU), the children were intravenously injected of pentazocine: 0.5 mg/kg (P1), 0.3 mg/kg (P2) and 0.9% NaCl (NS), respectively. Coughing score, Ramsay sedation score, pediatric anesthesia emergence delirium (PAED) and modified children's hospital of eastern ontario pain scale (m-CHEOPS) of the 3 groups were compared. Changes of HR, MBP, RR, SPO2 at each time point and the incidence of adverse events were observed and recorded. SPSS 19.0 software package was used for data processing. RESULTS: During the recovery period of general anesthesia, the Ramsay sedation score of group P1 and P2 was significantly higher than group NS(P<0.05) ; cough score of group P1 and P2 was significantly lower than group NS(P<0.05); PAED score and m-CHEOPS score of group P1 was significantly lower than group NS(P<0.01); group P2 was lower than group NS, but the difference was not significant(P>0.05). There was no significant difference in recovery time and the adverse reaction between the 3 groups (P>0.05). CONCLUSIONS: Injection of pentazocine after operation can effectively reduce the incidence of agitation during the recovery period of general anesthesia in children who received cleft palate surgery, and the children in the recovery period are more stable and safer, the recommended dose of pentazocine is 0.5 mg/kg.

Key words: Pentazocine, Cleft palate, Emergence agitation, Children, General anesthesia

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