小剂量舒芬太尼超前镇痛对小儿腹腔镜手术后情绪的影响

The influence of small dose of sufentanil in preemptive analgesia on emotional state after pediatric laparoscopic surgery

目的：探讨小剂量舒芬太尼超前镇痛对小儿腹腔镜手术后情绪的影响。方法：选取择期行腹腔镜手术的患儿60例，随机分为实验组（n=30）与对照组（n=30），均采用气管插管全麻，其中实验组采用舒芬太尼O．2μg/kg诱导插管，对照组采用瑞芬太尼1—2μg／kg诱导插管，术毕观察两组患儿停药至自主呼吸恢复时间、拔管时间、恢复室留观时间，监测拔管后30min、1h、2h、4h、8h、24h的BP、RR、HR、SpO2、PETCO2，记录两组患儿FPS-R评分、情绪评分、躁动评分，并进行对比分析。结果：两组拔管时间、拔管后各时段BP、RR、SPO。PEa,CO：的变化差异无统计学意义（P〉0．05）；实验组心率变化较对照组平稳，差异有统计学意义（P〈0．05）；实验组FPS—R评分、躁动评分均小于对照组；而情绪评分实验组大于对照组，差异有统计学意义（P〈0．05）；恢复室留观时间两组差异有统计学意义（P〈0．05）。结论：小剂量舒芬太尼超前镇痛可有效控制小儿腹腔镜手术后的情绪．减少因惠儿长时间哭闹、躁动带来的不利影响．应用于小儿腹腔镜手术是安全、可行的。

Objective： To explore the influence of small dose of sufentanil in preemptive analgesia on emotional state after pedi- atric laparoscopic surgery. Methods：There were 60 children undergoing general anesthesia in elective laparoscopic surgeries, who were randomly divided into two groups ： test group （ sufentanil group） and control group （ remifentanil group）. Tracheal intubation after anes- thesia induction was used in both groups, among which ,0.2 μg/kg sufentanil was used in the test group and 1-2μg/kg remifentanil was used in the control group for anesthesia induction. After the surgery, the recovery time between drug withdrawal and spontaneous breath- ing, the time of extubation, and the time of patients staying in recovery room were observed. Patients＇ BP, RR, HR, SpO2, PrTCO2 were monitored, FPS-R score, emotional score and restlessness score were recorded in 30 min, 1 h,2 h,4 h,8 h,24 h respectively after extu- bation. Then the two sets of data were comparatively analyzed. Results： There were no significant differences in the extubation time, and changes of BP, RR, SpO2, PETCO2 during each time interval （P 〈 O. 05 ）. However, the test group showed statistically steadier heart rate changes （ P 〈 0.05 ）. The test group also showed statistically lower FPS-R ratings and restlessness ratings, while they showed statistical- ly higher emotional scores （P 〈 O. 05 ）. In addition, the difference in the time of staying in recovery room was statistically significant （P 〈 0.05 ）. Conclusions： Small dose of sufentanil used in preemptive analgesia can effectively control postoperative emotion after pediat- ric laparoscopic surgery. Meanwhile,it can reduce the adverse effect of prolonged cry and restlessness. It can be used safely in pediatric laparoscopic surgery.