冰棒对七氟烷全麻儿童龋齿充填术苏醒期躁动的治疗作用

Effect of ice popsicle on the treatment of emergence agitation in children undergoing dental filling surgery with sevoflurane anesthesia.

目的评价术后食用冰棒治疗七氟烷全麻龋齿充填术儿童患者苏醒期躁动的有效性及安全性。方法选取七氟烷全麻龋齿充填术苏醒期躁动儿童患者60例,按照随机数字表分为3组:对照组(C组)、冰棒组(I组)和纳布啡组(N组)。被诊断为苏醒期躁动后,C组由父母进行语言安抚和鼓励,I组采用奖励患儿食用冰棒,N组静脉注射纳布啡0.01 mg/kg。观察并记录躁动评分,疼痛情况、循环体征以及恶心呕吐等不良反应的发生情况。结果C组、I组和N组治疗后躁动的持续时间分别为(13.6±2.9)、(5.6±1.9)和(5.3±2.0)min,I和N组与C组比较均差异有统计学意义(P<0.05)。治疗后5~20 min,I组和N组躁动评分明显减小,与C组相比,皆差异有统计学意义(P<0.05);I组在躁动治疗后20 min苏醒期躁动评分比N组评分更低,差异有统计学意义(P<0.05)。且I组和N组术后疼痛评分峰值明显下降(P<0.05)。C组术后最大心率升高值明显高于I组和N组(P<0.05)。3组术后恶心呕吐发生率差异无统计学意义(P>0.05)。结论食用冰棒用于七氟烷全麻龋齿充填术儿童患者苏醒期躁动的治疗效果确切,安全性好。其是替代纳布啡等麻醉药物治疗苏醒期躁动的有效物理治疗方法。

Objective To evaluate the efficacy and safety of postoperative ice popsicles on the treatment of emer-gence agitation in children undergoing dental filling surgery with sevoflurane anesthesia.Methods In this study,60 children with emergence agitation after dental filling surgery with sevoflurane anesthesia were selected and divided into three groups according to the random number table,control group(Group C),ice popsicle group(Group I)and nalbu-phine group(Group N).After being diagnosed with emergence agitation during the recovery period,children in Group C received verbal comfort and encouragement from their parents.Children in Group I were rewarded with ice popsicles,and children in Group N was given with intravenous nalbuphine 0.01 mg/kg.The agitation score,pain,circulation signs,and the occurrence of adverse events such as nausea and vomiting were observed and recorded.Results The average duration of agitation was 13.6±2.9,5.6±1.9 and 5.3±2.0 minutes in control group,ice popsicle group and nalbuphine group,respectively(compared with group C,both P<0.05).From 5 minutes to 20 minutes after treatment,compared with Group C,agitation scores of Groups I and N were significantly reduced(compared with group C,both P<0.05);and ag-itation score in Group I was significantly lower than that in Group N at 20 minutes after treatment.The peak postoperative pain scores of Groups I and N were significantly reduced(P<0.05).The maximum heart rate increase in Group C was significantly higher than those in both Group I and N(P<0.05).There was no significant difference in the incidence of postoperative nausea or vomiting among the three groups(P>0.05).Conclusion Ice popsicles are effective and safe in the treatment of emergence agitation in children undergoing sevoflurane anesthesia for dental filling surgery.It is an effec-tive physical therapy method to replace anesthetic drugs such as nalbuphine in the treatment of emergence agitation,and highly accepted by parents.