不同剂量舒芬太尼复合右美托咪定对小儿腺样体切除术后躁动的影响

Effects of different doses of sufentanil combined with dexmedetomidine on agitation after adenoidectomy in children

目的探讨不同剂量舒芬太尼复合右美托咪定对小儿腺样体切除术后躁动的影响。方法选择腺样体肥大患儿81例,随机分为:麻醉诱导A组采用舒芬太尼0.1μg/kg,B组为舒芬太尼0.2μg/kg,C组为舒芬太尼0.3μg/kg,3组均应用右美托咪定0.5μg/kg,术中采用七氟烷复合瑞芬太尼麻醉维持。记录患儿拔管后躁动发生率和不良反应等指标。结果与A组相比,B组和C组患儿躁动发生率降低(P<0.05),术后早期行为疼痛评分(FLACC)降低(P<0.05),拔管后追加镇痛药物例数减少(P<0.05),拔管呛咳发生率低(P<0.05)。与C组相比,A组、B组患儿自主呼吸恢复时间、拔管时间、麻醉恢复室(PACU)停留时间短(P<0.05)。结论舒芬太尼0.2μg/kg复合右美托咪定应用在小儿腺样体切除术中拔管后躁动发生率少,安全性更高。

Objective The purpose of this study was to see how different doses of sufentanil combined with dexmedetomidine affected agitation after adenoidectomy in children.Methods Eighty-one children with adenoid hypertrophy were randomly divided into three groups according to different doses of sufentanil.During anesthesia induction,group A was given sufentanil 0.1μg/kg,group B was given sufentanil 0.2μg/kg,group C was given sufentanil 0.3μg/kg.After induction,the three groups were combined with dexmedetomidine 0.5μg/kg,sevoflurane combined with remifentanil was used for anesthesia maintenance.The incidence of agitation and adverse reactions after extubation were recorded.Results Compared with group A,the incidence of agitation,FLACC score of early postoperative analgesia,the number of additional analgesics and the incidence of cough after extubation were lower in group B and group C(P<0.05).Compared with group C,the recovery time of spontaneous breathing,extubation time and PACU stay time of group A and group B were shorter(P<0.05).Conclusion In children,sufentanil 0.2μg/kg combined with dexmedetomidine reduces agitation and improves safety during adenoidectomy.