预防性使用艾司氯胺酮对扁桃体腺样体切除患儿苏醒期质量的影响

Effect of Preventive Use of Esketamine on the Quality of the Awakening Period in Children with Tonsil Adenoidectomy

目的探究预防性使用艾司氯胺酮对扁桃体腺样体切除患儿苏醒期质量的影响。方法选取206例扁桃体腺样体切除患儿作为观察对象,使用分层随机化法分为观察组和对照组,各103例。对照组麻醉前进行常规预防性措施,观察组患儿麻醉前给予适量艾司氯胺酮。比较2组患儿拔管时间,术中20 min血压、心率,恶心呕吐、低氧血症等不良反应发生情况;比较2组患儿入恢复室后15 min(T1)、30 min(T2)疼痛情况[行为学评分量表(FLACC)]、躁动情况[麻醉苏醒期躁动量表(PAED)评分]的变化。结果观察组患儿拔管时间(11.74±1.67)min,短于对照组(12.69±2.03)min,差异有统计学意义(P<0.05);2组患儿手术进行20 min时收缩压、舒张压、心率比较,差异无统计学意义(P>0.05);观察组患儿不良反应发生率低于对照组,差异有统计学意义(P<0.05);观察组患儿在T1、T2时,FLACC、PAED评分均低于对照组,差异有统计学意义(P<0.05)。结论麻醉前预防性使用艾司氯胺酮,能有效降低扁桃体腺样体切除患儿术后不良反应及苏醒期躁动发生率,对于患儿康复有利。

Objective To investigate the effect of prophylactic use of esketamine on the quality of the awakening period in children with tonsil adenoidectom.Methods A total of 206 children with tonsil adenoidectomy were selected for observation and divided into an observation group and a control group using stratified randomization,103 cases in each group.The control group received routine preventive measures before anesthesia,and the observation group received appropriate esketamine before anesthesia.The extubation time and intraoperative blood pressure,heart rate,nausea,vomiting,hypoxemia and other adverse reactions after 20 minutes of operation were compared between the two groups.We compared the changes in pain[Behavioral score(FLACC)]and agitation[Agitation during Awakening from Anesthesia Rating Scale(PAED)]at 15 min(T1)and 30 min(T2)after admission to the recovery room in the 2 groups of children.Results The extubation time of the children in the observation group was shorter(11.74±1.67)min than that of the control group(12.69±2.03)min,and the difference was statistically significant(P<0.05).And there was no statistical difference between the two groups in systolic blood pressure,diastolic blood pressure and heart rate after 20 minutes of operation(P>0.05).The incidence of adverse reactions in observation group was significantly lower than that in control group(P<0.05).FLACC and PAED scores in observation group were significantly lower than those in control group at T1 and T2(P<0.05).Conclusion The preventive use of esketamine before anesthesia can effectively reduce the incidence of postoperative adverse reactions and agitation during awakening in children with tonsil adenoidectomy,which is beneficial for their recovery.