等效剂量地佐辛或芬太尼在小儿扁桃体手术中的临床疗效观察

Observation on Clinical Efficacy of Equivalent Dose of Dezocine or Fentanyl During Child Droperidol Tonsillectomy Surgery

目的:观察等效剂量地佐辛或芬太尼在小儿扁桃体手术中的临床疗效。方法60例择期行扁桃体手术患儿,年龄3~5岁,体重13~20kg,ASAI级,随机分为地佐辛组(D组)和芬太尼组(F组)(n=30),均实施静吸复合麻醉。在插管前5min分别静脉注射地佐辛0.1mg/kg(D组)、芬太尼2μg/kg(F组),其余诱导药相同,丙泊酚2.5mg/kg,苯磺顺阿曲库铵0.15mg/kg,8%七氟醚吸入2min。观察两组患儿诱导前(T0)、插管前1min(T1)、插管后即刻(T2)、插管后5min(T3)和拔管后1min(T4)、5min(T5)、15min(T6)的HR、MAP、SpO2、ETCO2,T4-6潮气量(VT)、呼吸频率(RR)及诱导期和苏醒期不良反应发生情况。结果两组患儿的手术时间、麻醉时间、HR、MAP、SpO2等组间比较无统计学差异(P>0.05)。与T0比较,D和F组T4-T5 ETCO2均增高,F组T4 RR降低(P<0.05)(P<0.05)。D组术后苏醒时间较长,镇静满意率较高,术后躁动发生率较低(P<0.05)。结论地佐辛可安全用于小儿扁桃体手术的麻醉,较芬太尼能降低术后不良反应的发生率。

Objective To detect the clinical ef icacy of equivalent dose of dezocine or fentanyl during child droperidol tonsillectomy surgery.Methods 60 elective droperidol tonsil ectomy surgery children patients aged 3~5 years,weighted 13~20 kg,ASAIwere selected and randomly divided into 2 groups with 30 in each,the dezocine group(group D)and the fentanyl group(group F).The 2 groups adopted intravenous inhalation anesthesia.Dezocine 0.1 mg/kg(group D)and fentanyl 2.0μg/kg(group F)were givrn with intravenous injection before 5 min of inserting tracheal catheter,Propofol 2.5mg/kg,Benzene sulfonyl cisatracurium 0.15mg/kg,and 8%Sevoflurane inhalation 2 min.Heart rate(HR)、mean arterial pressure(MAP)、pulse oxygen saturation(SpO2)、end tidal carbon dioxide patial pressure(ETCO2)、tidal volume(VT)、respiratory rate(RR)and situation of recovery period were recorded before induction(T0),1 min before inserting tracheal catheter(T1),immediately(T2)、5 min(T3)after inserting tracheal catheter and 1 min(T4)、5 min(T5)、15 min(T6)after pulting tracheal catheter.Results No significant dif erence was found between the 2 groups in operation time,anesthetic time,HR、MAP、SpO2(>0.05).Compared with at T0,the levels of ETCO2 at T4~T5 were increased in group D and F(<0.05),the levels of RR at T4 were decreased significantly in group F(<0.05);Compared with group F,the wake-up time was longer and the incidence of agitation at recovery period was lower in group D(<0.05).Conclusion Dezocine was safty during child droperidol tonsil ectomy surgery and it could relieve the incidence of adverse ef ect post-operation compared with fentanyl.