酮咯酸氨丁三醇对腹腔镜胆囊切除术七氟烷全麻苏醒期躁动的影响

Effects of ketorolac tromethamine on the agitations after sevoflurane anaesthesia

目的:观察酮咯酸氨丁三醇对七氟烷全麻苏醒期躁动的影响。方法:选择拟行腹腔镜胆囊切除术(LC)的患者60例,ASAⅠ～Ⅱ级,随机分为酮咯酸氨丁三醇30 mg组(K组)(n=30)和对照组(C组)(n=30)。K组手术切皮前15min缓慢静脉推注酮咯酸氨丁三醇30mg(0.9%氯化钠溶液稀释至10ml),C组手术切皮前15min给予生理盐水10ml静脉注射。观察患者的苏醒时间,拔管时的RSS躁动评分、拔管后5min的镇静评分(Ramsay)、VAS评分及药物的不良反应。结果:K组的VAS评分、躁动评分和发生率明显低于C组(P<0.01),拔管后5min的镇静评分高于C组(P<0.01),术后苏醒时间无明显差异,两组的不良反应发生率差异无统计学意义(P>0.05)。结论:酮咯酸氨丁三醇可有效预防或减少七氟烷全麻患者苏醒期的躁动,无明显不良反应。

Objective To observe the effects of ketorolac tromethamine for the agitations during anesthesia recovery period after sevoflurane anaesthesia. Methods Sixty ASA Ⅰ or Ⅱ grade patients who were scheduled for laparoscopic cholecystectomy（LC）,were randomly divided into group K （n=30） received IV ketorolac tromethamine 30 mg and group C （control group,n=30）.Group K and group C were injected intravenously 30 mg ketorolac tromethamine （diluted to 10ml by 0.9% sodium chloride solution） and 10 ml normal saline respectively 15 min before operations.The recovery time of patients.The RSS agitation scale at endotracheal extubation, rammsay sedation scale 5 min after enclotracheal extubation, visual analog scale,and adverse events were assessed. Results VAS, the scale and incidence of agitation of group C were significantly higher than those of group K （P 〈 0.01）,Ramsay sedation score of group K was higher than that of group C 5 min after extubation （P〈0.01）.There were no significantly difference in two groups for the adverse events and recovery time （P 〉0.05）. Conclusion Ketorolac tromethamine can effectively alleviate the agitations after sevoflurane anaesthesia,and has-little side effects.