艾司氯氨酮复合右美托咪定用于七氟烷麻醉下小儿扁桃体腺样体切除术的效果及对术后谵妄的影响

Application of esketamine combined with dexmedetomidine in pediatric adeno tonsillectomy under sevoflurane anesthesia and its influence on postoperative delirium

目的分析艾司氯氨酮复合右美托咪定用于七氟烷麻醉下小儿扁桃体腺样体切除术的效果及对术后谵妄的影响。方法抽取2021年5月至2023年5月于平煤神马医疗集团总医院行扁桃体腺样体切除术106例患儿的临床资料进行回顾性分析。按照是否给予艾司氯氨酮复合右美托咪定注射将其分为对照组(53例,否)和观察组(53例,是)。比较两组术后4、6、12、24 h疼痛评分,比较两组麻醉苏醒期和术后2、6、12、24 h谵妄风险评分,统计两组谵妄发生情况。结果术后4、6、12、24 h,观察组疼痛评分低于对照组(P<0.05)。麻醉苏醒期和术后2、6、12、24 h,观察组谵妄风险评分均低于对照组(P均<0.05)。对照组术后发生谵妄8例(15.09%,8/53),观察组术后发生谵妄2例(3.77%,2/53),观察组术后谵妄发生率低于对照组(P<0.05)。结论艾司氯氨酮复合右美托咪定用于七氟烷麻醉下小儿扁桃体腺样体切除术的效果良好,可以减轻患儿术后疼痛程度,降低术后谵妄发生率。

Objective To analyze the application effect of esketamine combined with dexmedetomidine in pediatric adeno tonsillectomy under sevoflurane anesthesia and its influence on postoperative delirium.Methods The clinical data of 106 children who underwent adeno tonsillectomy in Pingmei Shenma Medical Group General Hospital from May 2021 to May 2023 were retrospectively analyzed.And they were divided into a control group(53 cases,without esketamine combined with dexmedetomidine)and an observation group(53 cases,with esketamine combined with dexmedetomidine)according to whether esketamine combined with dexmedetomidine injection was given or not.The pain scores of the two groups at 4,6,12 and 24 hours after surgery were compared.The delirium risk scores of the two groups during the anesthesia recovery period and at 2,6,12 and 24 hours after surgery were compared between the two groups;the occurrence of delirium in the two groups was statistically counted.Results At 4,6,12 and 24 hours after surgery,the pain scores of the observation group were lower than those of the control group(P<0.05).The delirium risk scores during the recovery period and at 2,6,12,and 24 hours after surgery of the observation group were lower than those of the control group(P<0.05).Eight cases(15.09%,8/53)in the control group developed delirium,and 2 cases(3.77%,2/53)in the observation group developed delirium.The incidence of postoperative delirium in the observation group was lower than that in the control group(P<0.05).Conclusions Esketamine combined with dexmedetomidine has a good effect in pediatric adeno tonsillectomy under sevoflurane anesthesia,which can reduce the postoperative pain and incidence of postoperative delirium.