丙泊酚联合七氟烷对扁桃体患儿麻醉苏醒质量的影响

Effect of Propofol Combined with Sevoflurane on the Quality of Anesthetic Awakening in Children Undergoing Tonsillectomy

目的:探讨丙泊酚联合七氟烷对小儿扁桃体切除术麻醉苏醒质量的影响。方法:选取2019年1月至2023年12月江西省信丰县人民医院符合纳入标准的行扁桃体切除术患儿80例,分为研究组和对照组,每组40例。研究组患儿选择丙泊酚联合七氟烷麻醉,对照组患儿通过七氟烷进行麻醉,比较两组患儿的拔管时间、麻醉苏醒时间、苏醒期躁动(EV)持续>15min发病率和不良反应发生率情况;比较两组患儿麻醉诱导前(T_(0))、术后即刻(T_(1))、拔管即刻(T_(2))、拔管5min(T_(3))、拔管10min时(T_(4))患儿血流动力学指标[心率(HR)、平均动脉压(MAP)]变化情况;比较患儿T_(2)、T_(3)和T_(4)时的苏醒期烦躁量表(Watcha)和行为学疼痛评分(FLACC)评分。结果:(1)两组患儿的拔管时间、麻醉苏醒时间均无统计学差异(均P>0.05),研究组患儿EA>15min发生率显著低于对照组(P<0.05);(2)研究组患儿T_(0)时的HR与对照组无显著性差异(P>0.05),T_(1)~T_(4)时研究组患儿HR显著低于对照组(均P<0.05);研究组患儿T_(0)时的MAP与对照组无显著性差异(P>0.05),T_(1)~T_(4)时研究组患儿MAP显著低于对照组(均P<0.05);(3)研究组患儿T_(2)、T_(3)和T_(4)时的Watcha躁动评分和FLACC疼痛评分均低于对照组(均P<0.05);(4)不良反应呕吐、恶心、呛咳等研究组患儿总体发生率低于对照组,但差异均无统计学意义(P>0.05)。结论:小儿扁桃体切除术应用丙泊酚联合七氟烷麻醉有利于维持患儿拔管期间的血流稳定,降低EV发生率,缓解术后疼痛,值得临床推广。

Objective:To investigate the effect of propofol combined with sevoflurane on the quality of anesthetic awakening in children undergoing tonsillectomy.Methods:From January 2019 to December 2023,80 children with tonsillectomy who met the inclusion criteria were selected and divided into study group and control group,with 40 cases in each group.Children in the study group were selected for combined anesthesia with propofol and sevoflurane,and the children in the control group were anesthetized with sevoflurane.The extubation time,anesthesia recovery time,incidence of emergence agitation(EV)>15min and adverse reactions rate were compared.The changes of hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP)]before anesthesia induction(T_(0)),immediately after operation(T_(1)),immediately after extubation(T_(2)),5min after extubation(T_(3))and 10 min after extubation(T_(4))were compared.The scores of Watcha and FLACC at T_(2),T_(3)and T_(4)were compared.Results:Firstly,the differences of extubation time,anesthesia time,HR and MAP at T_(0)time between the two groups were small(both P>0.05),indicate that the anesthetic effect was satisfactory.Secondly,at T_(1)-T_(4),the incidence of EV,HR and MAP in the study group were significantly lower than those in the control group(both P<0.05),indicate the blood flow was stable,and the incidence of agitation was underground,finally,adverse reactions such as vomiting,nausea,and cough occurred in both groups,and the study group was lower,but the difference was not significant(both P>0.05).Conclusion:The application of propofol combined with sevoflurane anesthesia in pediatric tonsillectomy is beneficial to the hemodynamic stability,reduce the incidence of EV,and relieve postoperative pain,which is worthy of clinical promotion.