艾司氯胺酮对采用低温等离子手术治疗的腺样体肥大患儿苏醒期躁动及疼痛程度的影响

Effect of Esketamine on Emergence Agitation and Pain in Children with Adenoid Hypertrophy Treated with Low Temperature Plasma Surgery

目的分析艾司氯胺酮对采用低温等离子手术治疗的腺样体肥大患儿的影响。方法选取2021年9月—2023年9月无锡市儿童医院采用低温等离子手术治疗的82例腺样体肥大患儿为研究对象,按随机数字表法将其分为对照组和观察组,每组41例。观察组采用艾司氯胺酮麻醉诱导,对照组采用芬太尼行麻醉诱导。对比两组的血流动力学、手术情况、疼痛程度、苏醒期躁动发生情况、不良反应发生情况。结果T1、T2时刻,观察组心率、平均动脉压水平均低于对照组,组间差异有统计学意义(P<0.05);观察组拔管时间、麻醉后监测治疗室停留时间均短于对照组,组间差异有统计学意义(P<0.05)。术后15 min、术后30 min,观察组儿童疼痛行为量表评分均低于对照组,差异有统计学意义(P<0.05)。观察组苏醒期躁动发生率为4.88%,低于对照组的21.95%,差异有统计学意义(P<0.05)。两组不良反应发生情况对比,差异无统计学意义(P>0.05)。结论艾司氯胺酮应用于采用低温等离子手术治疗的腺样体肥大患儿中,可维持血流动力学指标稳定,减少苏醒期躁动发生风险,缓解术后疼痛,且安全性高。

Objective To analyze the effect of esketamine on children with adenoid hypertrophy treated with low temperature plasma surgery.Methods A total of 82 children with adenoid hypertrophy treated by low temperature plasma surgery in Wuxi Children's Hospital from September 2021 to September 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 41 cases in each group.The observation group was anesthetized with esketamine,and the control group was anesthetized with fentanyl.The hemodynamics,operation conditions,pain degree,occurrence of emergence agitation and adverse reactions were compared between the two groups.Results At T1 and T2,the heart rate and mean arterial pressure of the observation group were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05);the extubation time and the stay time in the treatment room after anesthesia in the observation group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05).Pain behavior scale scores in observation group were lower than those in control group 15 min and 30 min after surgery,and the difference was statistically significant(P<0.05).The incidence of emergence agitation in the observation group was 4.88%,which was lower than 21.95% in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions between the two groups was compared,and the difference was no statistically significant(P>0.05).Conclusion The application of esketamine in children with adenoid hypertrophy treated with low temperature plasma surgery can maintain stable hemodynamic indicators,reduces the risk of emergence agitation,alleviates postoperative pain,and it has high safety.