布托啡诺联合利多卡因胶浆预处理对隐匿阴茎患儿术后躁动的影响

Efficacy of Butorphanol Combined with Lidocaine Mortar Pretreatment on Emergence Agitation in Pediatrics with Concealed Penis

目的探讨布托啡诺联合利多卡因胶浆预处理对隐匿阴茎患儿术后躁动的影响。方法选择择期行手术治疗的隐匿阴茎患儿50例,随机分为两组,预处理组(P组)和对照组(C组),每组各25例,P组患儿手术结束前10min经静脉给予布托啡诺20μg/kg,手术结束时用利多卡因胶浆3ml充分润滑尿道后留置导尿管,C组患儿手术结束前10min经静脉给予等容量生理盐水,手术结束时用石蜡油3ml充分润滑尿道后留置导尿管,所有患儿手术结束后均送往PACU。观察并记录两组患者术后苏醒时间、定向力恢复时间、PACU停留时间;术后用于躁动镇静的异丙酚用量,术后24h曲马多需求量,观察期间术后躁动、皮肤瘙痒、呼吸抑制、恶心呕吐的发生情况。结果 P组患儿的苏醒时间、定向力恢复时间及PACU停留时间与C组比较差异无统计学意义(P>0.05),P组患儿异丙酚用量,术后24h曲马多需求量明显低于C组,差异有统计学意义(P<0.01),二组患儿在呼吸抑制、皮肤瘙痒、恶心、呕吐等不良反应方面,差异无统计学意义(P>0.05),P组患儿术后躁动发生率显著低于C组,差异有统计学意义(P<0.05)。结论布托啡诺联合利多卡因胶浆预处理能明显减少患儿苏醒期躁动的发生率,减少患儿对镇痛药物的需求量且无明显不良反应。

Objective To investigate the efficacy of butorphanol combined with lidocaiue mortar pretreatment on emergence agitation in pediatrics with concealed penis. Methods Fifty pediatrics with concealed penis （ASA status I or II ） were randomly divided into two groups ：the pretreatment group （P group, n = 25 ） and the control group （group C, n = 25 ）. Pediatrics in Group B were intravenous injected butorphanol 20μg/kg ten minutes before the end of the operation and indwelled Catheters after lidocaine mortar 2ml adequately lubricated urethra at the end of operation. Those in Group C were intravenous injected normal saline solution and indwelled Catheters after paraffin 2ml sufficiently lubricated urethra at the end of operation. All patients were admitted to the PACU after operation. The recovery time, the directional force recovery time, the time of staying in PACU,the dosage of propofol for sedation,the 24 hours consumption of tramadol were observed and recorded. The postoperative agitation, skin itch, respiratory depression, the incidence of nausea and vomiting during the observation after operation were also recorded. Results The recovery time, orientation force recovery time and the time of staying in PACU in group P had no statistical significance compared with those in group C （ P 〉 0.05 ）. The dosage of propofol for sedation, the 24 hours consumption of tramadol in group P was significantly lower than that in group C, and the difference was statistically significant （ P 〈 0.01）. The adverse reaction in the two groups such as respiratory depression, nausea, vomiting and skin itch were no significant different （ P 〉 0.05 ）, but postoperative agitation rate in group P was significantly lower than that in group C （ P 〈 0.05 ）. Conclusion The pretreatment of butorphanol combined with lidocaine mucilage can significantly reduce the incidence of postoperative emergence agitation with no obvious adverse reaction in children with concealed penis. It can also reduce the consumption of analgesic and sedative drugs after operation.