不同剂量地佐辛预防小儿扁桃体全身麻醉切除术苏醒期躁动

Effects of different doses of dezocine on postoperative agitation in children patients undergoing tonsillectomy under general anesthesia:Comparative study

目的观察不同剂量地佐辛预防小儿扁桃体切除术苏醒期躁动的临床效果和安全性。方法选择ASAⅠ~Ⅱ级在七氟烷复合瑞芬太尼全麻（全身麻醉）下行扁桃体切除术的患者80例。随机分为对照组（C组）、地佐辛0.1 mg/kg组（D1组）、地佐辛0.15 mg/kg组（D2组）和地佐辛0.2 mg/kg组（D3组）各20例;麻醉前C组患者注射生理盐水5 ml,D1~3组注射不同剂量地佐辛。记录小儿麻醉时间、手术时间、拔除气管导管时间、苏醒时间、躁动评分及躁动例数。结果四组患者的自主呼吸恢复时间、苏醒时间、拔管时间及呼吸抑制方面差异无统计学意义。与C组比较,D1~3组躁动评分1分及2分病例数增加,3分及4分病例数减少;与D1组比较,D2~3组躁动评分1分病例数增加,3分病例数减少;差异有统计学意义（P〈0.05）。与对照组或D1、D2组分别比较,D3组恶心呕吐发生例数增加,差异有统计学意义（P〈0.05）。结论术前静脉注射地佐辛0.15 mg/kg能有效预防小儿全麻术后躁动,且没有呼吸抑制作用,不良反应少,是预防小儿全麻术后躁动的安全选择。

Objective To explore the influence of different doses of dezocine on postoperative agitation in children patients undergoing tonsillectomy under general anesthesia. Methods Eighty ASA Ⅰ or Ⅱ children patients undergoing elective tonsillectomy were randomly divided into four groups,with 20 cases in each one. The four groups were respectively given 0.10 mg / kg of intravenous dezocine（group D1）,0.15 mg / kg of intravenous dezocine（group D2）,0.20 mg / kg of intravenous dezocine（group D3） and 0.9% sodium chloride injection 5 ml（group C） before anesthesia. The postoperative recovery time of spontaneous breathing and awakening,the extubation time,the postoperative agitation score（RS） were also recorded. Results There were no statistically significant differences on spontaneous breathing recovery time,awakening time,extubation time and of respiratory depression in all patients（P〉0.05）. Compared with group C,the cases of RS was 1 and 2 increased and the cases of RS was 3 and 4 decreased in group D1-3. Compared with group D1,the cases of RS was 1 increased and the cases of RS was 3 decreased in group D2-3. Compared with group C or group D1 or group D2,the casea of nausea and vomiting in group D3 increased,the difference was statistically significant（P〈0.05）.Conclusion Different doses of dezocine can all effectively inhibit the postoperative agitation,0.15 mg / kg of intravenous dezocine is preferred.