超前应用氟比洛芬酯对小儿全麻苏醒期躁动的影响

EFFECTS OF ADVANCED TREATMENT OF FLURBIPROFEN AXETIL ON CHILDREN WITH RESTLESSNESS DURING RECOVERY

目的小儿在全凭静脉麻醉下行扁桃体切除和腺样体切除术后可能会发生苏醒期躁动。本研究采用小儿麻醉苏醒期躁动量化评分表(PAED)比较超前应用氟比洛芬酯对全凭静脉麻醉下行扁桃体切除和腺样体切除术患儿的苏醒期躁动反应。方法选择择期行扁桃体切除术和腺样体切除术的患儿60例,ASAⅠ～Ⅱ级,年龄2～10岁,随机分成生理盐水对照组(Ⅰ组)和氟比洛芬酯组(Ⅱ组)。所有患儿采用静脉注射咪哒唑仑0.04～0.05mg/kg,舒芬太尼0.2～0.3μg/kg,罗库溴铵0.6～0.8mg/kg,丙泊酚2～3mg/kg进行麻醉诱导,行气管内插管,Ⅰ组给予生理盐水2ml,Ⅱ组给予氟比洛芬酯1mg/kg。术中均静脉靶控输注瑞芬太尼和丙泊酚维持麻醉。评价其拔管时间、苏醒期反应、恢复期疼痛评分。结果二组患儿拔管时间比较差异无统计学意义(P>0.05)。在麻醉恢复室内氟比洛芬酯组患儿苏醒期躁动评分和疼痛评分明显低于对照组(P<0.05)。结论超前静脉滴注氟比洛芬酯可以减少术后疼痛和苏醒期躁动,可以较好的应用于扁桃体切除术和腺样体切除术。

Objective Restlessness may occur after general anesthesia in children undergoing operations of tonsillectomy and adenoidectomy. The aim of present study is to examine the restless behavior of children undergoing operations of tonsillectomy and adenoidectomy after total intravenous anesthesia （TIVA） using a published pediatric anesthesia emergence delirium （PAED） scale. Methods 60 children at ASA physical state Ⅰ - Ⅱ aged 2 yr to 10yr scheduled for tonsillectomy and adenoidectomy were studied. Children were randomly divided into control group （group Ⅱ） and flurbiprofen axetil group（group Ⅱ ）. Performance of anesthesia induction and maintenance were the same in two groups except that 2 ml physiological saline was injected in group Ⅱ , while in group Ⅱ ,1 mg/kg flurbiprofen axetil was given intravenously after anesthesia induction. Time to tracheal extubation, restless behavior, and pain score were assessed. Results Time to extubation was not significantly different between the groups. The PAED scale and the pain scale were significantly lower-in children receiving fflurbiprofen axetil than those of control group in postanesthesia care unit. Conclusion Flurbiprofen axetil can reduce postoperative pain and restlessness during recovery.