摘要
目的比较地佐辛和曲马多用于预防小儿全凭静脉下行扁桃体联合腺样体切除术后苏醒期躁动的有效性和安全性。方法选择60例在全麻下行双侧扁桃体联合腺样体切除术的患儿随机分为曲马多组、地佐辛组、对照组三组，每组20例。地佐辛组在气管插管后静脉注射生理盐水2 mL,在一侧标本切下后（大约手术结束前10～20 min）静注地佐辛0.1 mg/kg；曲马多组在气管插管后静脉注射曲马多2 mg/kg，一侧标本切下后静注生理盐水2 mL；对照组在两个时间点均注射生理盐水2 mL，观察三组患儿苏醒期的血流动力学变化、躁动评分、疼痛评分以及所有患儿的不良反应。结果拔管时和清醒时对照组患儿的MAP和HR高于曲马多组和地佐辛组，与麻醉前和停药时比较差异有统计学意义（P〈0.05）；对照组的躁动评分和疼痛评分均高于曲马多组和地佐辛组，比较差异有统计学意义（P〈0.05），地佐辛组与曲马多组比较差异无统计学意义；曲马多组中有8例出现恶心呕吐，地佐辛组和对照组有2例和3例出现呕吐，曲马多组与地佐辛组、对照组比较差异有统计学意义（P〈0.05）；三组患儿均无呼吸抑制。结论地佐辛和曲马多均可有效预防小儿全麻苏醒期躁动，维持苏醒期血流动力学稳定，但应用地佐辛恶心呕吐的发生率更低、更安全。
Objective To observe the effectiveness and security of dezocine and tramadol on the prevention of emergence agitation under general anaesthesia after adenotonsillectomy in children. Methods Sixty patients received adenotonsillectomy under general anesthesia were randomly divided into three groups ,dezocine group （administered intravenously injected 2 mL normal saline after intubation and intravenously injected 0.1 mg/kg dezocine 10~20 min before the end of operation）,tramadol group （administered intravenously injected tramadol 2 mg/kg after intubation and intravenously injected normal saline 10-20 min before the end of operation ）, control group （administered intravenously injected 2 mL normal saline at the two same time）.Observed and recorded the recovery and extubation time.The emergence agitation scores and pain scores and side effects. Results There were no significant differences in time of surgery ,recovery time and extubation time among the three groups.The MAP and HR were significantly higher in control group compared dezocine group and tramadol group at the time of recovery and extubation（P〈0.05）. the emergence agitation scores and pain scores in control group at every time points were significantly higher those in group dezocine and group tramadol（P〈0.05）.While there was no significant differences between group dezocine and group tramado. There were 8 patients experienced nause and vomiting in tramado group, which was statistically significant higher than that of dezocinegroup and tramadol group（P〈0.05）,there was no respiratory depressionin in all patients.Conclusion Administed intravenously 0.1 mg/kg and 2 mg/kg tramadol before the end of surgery are effective on the prevention of emergence agitation in children , so that patients hemodynamic stabilized in the waking period,but dezocine with lower incidence of nausea and vomiting,it is safer.
出处
《当代医学》
2014年第1期94-96,共3页
Contemporary Medicine
关键词
地佐辛
曲马多
全身麻醉
躁动
Dezoicine
Tramadol
General anesthesia
Emergence agitation
