盐酸纳美芬在小儿喉罩麻醉中的应用

Application of nalmefene hydrochloride in pediatric laryngeal mask anesthesia

目的·评价盐酸纳美芬用于小儿喉罩麻醉的临床效果。方法·选择手术时间短的眼科患儿60例,采用随机数字表法分为盐酸纳美芬组(N组)和对照组(C组),各30例。手术结束时N组和C组分别静脉注射盐酸纳美芬0.25μg/kg和相同容量的0.9%氯化钠注射液。记录给药后1、2、3、4、5 min的呼吸恢复情况,包括患儿的呼吸恢复时间及拔除喉罩时间。记录拔除喉罩后的镇静评分(Ramsay评分)以及术后不良反应的发生情况。结果·N组患儿5 min内呼吸恢复率高,3 min内呼吸恢复率为83.0%,而C组3 min内呼吸恢复率只有16.7%;N组呼吸恢复时间[(3.17±0.78)min]和拔除喉罩时间[(4.10±0.95)min]比C组明显缩短(均P<0.05)。2组的术后镇静评分无明显差异(P>0.05)。N组拔除喉罩后总的不良反应发生率低于C组(P<0.05)。结论·盐酸纳美芬用于小儿喉罩麻醉,能够有效缩短呼吸恢复时间及拔除喉罩时间,而且不影响患儿的镇静效果,术后呼吸不良反应发生率更低。

Objective·To evaluate clinical anesthetic effects of nalmefene hydrochloride in pediatric laryngeal mask anesthesia. Methods·Sixty pediatric patients who underwent short-time eye surgeries were randomly divided into nalmefene hydrochloride group(Group N) and the control group(Group C), 30 patients each group. At the end of the surgeries, patients of Group N and Group C were respectively given nalmefene hydrochloride at 0.25 μg/kg and 0.9% sodium chloride at the same volume intravenously. The situation of the patients' respiration recovery was recorded 1, 2, 3, 4 and 5 minutes after administration, including the time on which the patients' respiration was recovered and their laryngeal masks were removed. The sedation scores(Ramsay scores) and the incidence of adverse postoperative responses were recorded after the removal of the laryngeal mask. Results·The 5-minute respiration recovery rate was high in Group N, where the 3-minute respiration recovery rate was 83.0%, while only 16.7% in Group C. Besides, respiration recovery time [(3.17±0.78) min] and time for removing laryngeal mask [(4.10±0.95) min] in Group N were shorter than those of Group C(both P<0.05). No significant difference was found in postoperative sedation scores between these two groups(P>0.05). After removing laryngeal mask, the incidence of adverse responses was lower in Group N than that in Group C(P<0.05). Conclusion·Nalmefene hydrochloride is effective in shortening respiration recovery time and laryngeal masks removing time, but makes no difference in patients' sedative effects, with lower incidence of adverse postoperative respiratory responses.