纳布啡对儿童牙科全麻苏醒期躁动的影响

Effects of nalbuphine on agitation during recovery from general anesthesia in children’s dentistry

目的 研究纳布啡对儿童牙科全身麻醉(简称全麻)苏醒期躁动的影响。方法 选取重庆佑佑宝贝妇儿医院拟行牙科全麻的儿童48例作为研究对象,随机分为纳布啡组(N组)和芬太尼(F组),每组24例。N组以纳布啡0.3 mg/kg诱导,术毕注射0.1 mg/kg;F组则按芬太尼3μg/kg诱导,术毕注射1μg/kg。记录两组患儿围手术期各时间点生命体征、手术持续时间、呼吸恢复时间、拔管时间、睁眼时间、麻醉恢复室滞留时间、躁动、疼痛及不良反应情况。结果 N组仅有1例躁动发生,明显低于F组的7例(P<0.05),而两组术后疼痛和其他不良反应发生率比较差异均无统计学意义(P>0.05)。N组较F组自主呼吸恢复和拔管时间更短,睁眼时间更长(P<0.05)。两组麻醉恢复室滞留时间比较差异无统计学意义(P>0.05)。结论 纳布啡可有效降低儿童牙科全麻苏醒期躁动发生率,术后镇痛效果良好,且不良反应发生率低。

Objective To investigate the effect of nalbuphine on agitation during recovery from general dental anesthesia in children.Methods A total of 48 children who were to undergo general dental anesthesia were randomly divided into the nalbuphine group(group N) and the fentanyl(group F),with 24 cases in each group.Group N was induced with nalbuphine 0.3 mg/kg, and injected with 0.1 mg/kg after surgery.Group F was induced by fentanyl 3 μg/kg, and injected with 1 μg/kg after surgery.The vital signs, operation duration, respiratory recovery time, extubation time, eye-opening time, anesthesia recovery room retention time, restlessness, pain, and adverse reactions were recorded at each time point in the perioperative period of the two groups of the children.Results There was only one case of agitation in group N,which was significantly lower than seven cases in group F(P<0.05),while the incidence of postoperative pain and other adverse reactions had no significant differences between the two groups(P>0.05).Compared with group F,the recovery time of spontaneous breathing and extubation in group N was earlier, and the time of eye-opening was later(P<0.05),but the residence time in the anesthesia recovery room was not prolonged(P>0.05).Conclusion Nalbuphine can effectively reduce the incidence of agitation during recovery from general dental anesthesia in children, with good postoperative analgesia and a low incidence of adverse reactions.