舒芬太尼联合七氟烷复合麻醉用于小儿腺样体肥大切除术对血流动力学及术后躁动的影响

The effect of sufentanil combined with sevoflurane anesthesia on hemodynamics and postoperative agitation for pediatric adenoid hypertrophy resection

目的探索舒芬太尼联合七氟烷复合麻醉用于小儿腺样体肥大切除术对血流动力学及术后躁动的影响。方法前瞻性研究171例腺样体肥大切除术患儿,根据随机数字表法分为观察组86例和对照组85例。观察组行舒芬太尼联合七氟烷复合麻醉,对照组行丙泊酚复合瑞芬太尼麻醉,比较2组围手术期血流动力学以及术后躁动率、面部表情量表法(faces pain scale,FPS)评分、警觉/镇静清醒指数(observer′s assessment of alertness/sedation,OAAS)评分,并统计不良反应发生情况。结果2组血氧饱和度(pulse oxygen saturation,SpO_(2))、平均动脉压(mean arterial pressure,MAP)呈先降低再升高趋势,心率(heart rate,HR)呈先升高再降低趋势,观察组SpO_(2)、MAP、HR波动幅度大小对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。2组OAAS评分呈先降低再升高趋势,FPS评分呈先升高再降低趋势,观察组OAAS评分高于对照组,FPS评分低于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。观察组术后6 h、术后24 h、术后48 h躁动率均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论相比于丙泊酚复合瑞芬太尼麻醉,舒芬太尼联合七氟烷复合麻醉用于腺样体肥大切除术,可稳定血流动力学,降低术后躁动率,更加安全可靠。

Objective To explore the effect of sufentanil combined with sevoflurane anesthesia on hemodynamics and postoperative agitation in pediatric adenoid hypertrophy resection.Methods A prospective study of 171 children undergoing adenoid hypertrophy resection was performed.According to the random number table method,they were divided into the observation group(n=86)and the control group(n=85).The observation group was given sufentanil combined with sevoflurane anesthesia,and the control group was given propofol combined with remifentanil anesthesia.The perioperative hemodynamics,postoperative agitation rate,facial expression scale(FPS)score,and observer's assessment of alertness/sedation(OAAS)score were compared between two groups.The incidence of adverse reactions was calculated.Results Pulse oxygen saturation(SpO_(2))and mean arterial pressure(MAP)in the two groups showed a trend of decreasing initially and then increasing,and heart rate(HR)showed a trend of increasing initially and then decreasing.The difference of interaction between groups,time points,and time points between groups was statistically significant with respect to fluctuation range of SpO_(2),MAP and HR(P<0.05).The OAAS score of the two groups showed a trend of initial decreasing and then increasing,and the FPS score was increasing initially and then decreasing.The OAAS score of the observation group was higher than that of the control group,while the FPS score was lower than that of the control group.The difference in interaction between groups,time points,and time points between groups was statistically significant(P<0.05).The agitation rates of the observation group at 6 h,24 h and 48 h after operation were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with propofol combined with remifentanil anesthesia,sufentanil combined with sevoflurane anesthesia for adenoid hypertrophy resection can stabilize hemodynamics,and reduce postoperative agitation rate,which is safer and more reliable.