纳布啡预防学龄前儿童全麻斜视矫正术后负性行为的效果观察

Effects of nalbuphine on negative behaviors of preschool children after strabismus correction under general anesthesia

目的观察纳布啡对学龄前儿童全麻斜视矫正术后苏醒期躁动和不良行为的影响。方法选择2022年1月至2023年4月徐州医科大学附属徐州市立医院收治的斜视患儿160例,按照随机数字表法分为对照组和试验组,每组80例,试验组给予0.2 mg/kg纳布啡,对照组给予等容量的生理盐水。记录两组患儿一般手术指标、术前及术后改良耶鲁焦虑(mYPAS)评分、术后FLACC疼痛评分、术后躁动、术后不良行为改变以及恢复室内不良事件的发生情况。结果试验组患儿苏醒期躁动(17.50%vs.53.75%,P<0.05)及术后1 d不良行为改变的发生率均明显低于对照组(15.00%vs.31.25%,P<0.05);试验组患儿麻醉恢复室内mYPAS评分[(36.52±8.61)vs.(54.83±7.46)分]及FLACC疼痛评分[(2.61±0.21)vs.(4.50±0.22)分]均明显低于对照组(P<0.05),术后抓挠术眼的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论纳布啡可预防学龄前儿童全麻斜视矫正术后苏醒期躁动,同时降低术后1 d不良行为改变的发生率。

Objective To observe the effect of nalbuphine on restlessness and bad behavior in preschool children after strabismus correction under general anesthesia.Methods One hundred and sixty children with strabismus admitted to Xuzhou Municipal Hospital affiliated to Xuzhou Medical University from January 2022 to April 2023 were randomly divided into control group and experimental group according to a random number table method,with eighty cases in each group.The experimental group was given 0.2 mg/kg nalbuphine and the control group was given equal volume of normal saline.Record the baseline characteristics,modified Yale anxiety scale(mYPAS)scores before and after surgery,postoperative FLACC pain score,postoperative emergence agitation,changes in postoperative adverse behaviors and occurrence of adverse events in the postanesthesia care unit.Results The incidence of emergence agitation during the recovery period and negative postoperative behavioral changes on the 1st day after surgery in the experimental group was significantly lower than that in the control group(17.50%vs.53.75%,15.00%vs.31.25%,P<0.05).The scores of mYPAS[(36.52±8.61)vs.(54.83±7.46)]and FLACC[(2.61±0.21)vs.(4.50±0.22)]in the postanesthesia care unit of the experimental group were significantly lower than those in the control group(P<0.05),and the incidence of scratching the eye was significantly lower than that in the control group(P<0.05).Conclusion Nalbuphine can prevent emergence agitation during the recovery period after general anesthesia in preschool children after strabismus correction,while reducing the incidence of negative behavior changes on the 1st day after surgery.