The purpose of this paper is to explore the safe and effective dose of dexmedetomidin for the prevention of agitation and delirium during the awakening period for children undergoing general anesthesia. Samples of 989...The purpose of this paper is to explore the safe and effective dose of dexmedetomidin for the prevention of agitation and delirium during the awakening period for children undergoing general anesthesia. Samples of 989 cases are collected from children with comprehensive treatment of dental caries, and were randomly divided into four groups. Group A, group B and group C were intravenously at constant speed （60 mL/h）, 0.5 and 0.25 infusion with 1 μg/kg dexmedetomidine. Group D （control group） was intravenously saline at the same speed. The score of 5-point scale and the incidence of ED （emergency delirium） and EA （emergence agitation） in four groups were compared. Comparison of four groups of CHIPPS （children and infants postoperative pain） score, the amount of operation time and record seven halothane （TO）, time to stop cover drug withdrawal of laryngeal anesthesia （TM）, eye opening time （TE）, independent records of children at the time of ICU stay after anesthesia （TP）. Results show that there was no significant difference between the four groups （p 〉 0.05）, among which the TM in B, C groups was significantly higher than that in A, D groups （p 〈 0.05）. Group C was significantly higher than group B （p 〈 0.05）. There was no significant difference in TE and TP between the A, B, D groups （p 〉 0. 05）. TE in group C was significantly higher than that in groups A, D （p 〉 0. 05）. The TP of group C was significantly higher than that of groups A, D （p 〈 0.05）, but there was no significant difference between the B, C groups （p 〉 0.05）. The incidence rates of EA and ED in groups A and B were significantly lower than those in group D （p 〈 0.05）. Group C was significantly lower than group A （p 〈 0.05）. There was no significant difference between group C and group C （p 〉 0.05）. The CHIPPS score and sevoflurane dosage in groups A and B were significantly lower than those in group D （p 〈 0.05）. Group C was significantly lower than group A （p 〈 0.05）. There was no significant difference between group C （p 〉 0.05）. Conclusion： the dose of dexmetomidine 0.5 μg/kg in children with general anesthesia can prevent restlessness and delirium after operation.展开更多
Objective: To compare and analyze the effect and safety of double tube laryngeal mask and endotracheal intubation general anesthesia in fast track anesthesia for limb orthopaedic surgery in children with cerebral pals...Objective: To compare and analyze the effect and safety of double tube laryngeal mask and endotracheal intubation general anesthesia in fast track anesthesia for limb orthopaedic surgery in children with cerebral palsy. Methods: 78 children with cerebral palsy undergoing limb orthopedic surgery were randomly divided into laryngeal mask group and intubation group, with 39 cases in each group. The perioperative hemodynamic indexes, anesthesia effect related indexes, anesthesia related complications or adverse reaction rates of the two groups were observed and compared between the two groups. Results: When the two groups of children entered the room, there was no significant difference in MAP and HR (P > 0.05);MAP and HR of children in the intubation group were higher than those in the laryngeal mask anesthesia group (P Conclusion: Laryngeal mask is used to establish the airway of intravenous general anesthesia in limb orthopaedic surgery of children with cerebral palsy, which is conducive to the stability of children’s circulatory and respiratory system, to reduce the impact of narcotic drugs on children, to reduce the incidence of postoperative anesthesia related complications, and to improve the anesthetic effect. It meets the requirements of fast track anesthesia, and can be widely used in clinical practice.展开更多
目的 观察白噪声疗法联合动画视频应用于全身麻醉患儿的临床效果。方法 根据随机数表法,将2020年3月至2023年1月期间河南省儿童医院麻醉与围术期医学科收治的81例拟行全身麻醉患儿分为对照组(n=40,全身麻醉期间接受常规干预)和研究组(n=...目的 观察白噪声疗法联合动画视频应用于全身麻醉患儿的临床效果。方法 根据随机数表法,将2020年3月至2023年1月期间河南省儿童医院麻醉与围术期医学科收治的81例拟行全身麻醉患儿分为对照组(n=40,全身麻醉期间接受常规干预)和研究组(n=41,全身麻醉期间接受白噪声疗法联合动画视频干预),比较两组手术前后的应激反应[皮质醇(Cor)、促肾上腺激素(ACTH)、去甲肾上腺素(NE)]、各项量表评分[全身麻醉苏醒期躁动风险量表(EA风险量表)、儿童疼痛行为量表(FLACC)、改良耶鲁术前焦虑量表(m-YPAS)、诱导期合作量表(ICC)、照护者心理弹性量表(CD-RISC)]和血流动力学变化[心率(HR)、收缩压(SBP)、舒张压(DBP)]。结果 研究组患儿术后血清ACTH、Cor、NE水平分别为(96.48±7.39) pg/L、(21.46±2.74) pg/L、(386.32±30.08) ng/L,明显低于对照组的(104.28±8.18) pg/L、(28.06±3.69) pg/L、(422.68±33.46) ng/L,差异均有统计学意义(P<0.05);术后,研究组患儿的EA风险量表、m-YPAS、FLACC、ICC评分分别为(6.39±1.54)分、(32.27±3.42)分、(3.01±0.92)分、(2.49±0.58)分,明显低于对照组的(10.43±2.67)分、(41.04±4.36)分、(6.97±1.56)分、(4.55±0.63)分,CD-RISC评分为(86.94±5.24)分,明显高于对照组的(72.06±6.39)分,差异均有统计学意义(P<0.05);研究组患儿插管前(T1)、插管即刻(T2)、插管后5 min (T3)时间点的HR、SBP、DBP先下降后升高,且研究组患儿T1、T2、T3时间点的HR [(78.62±4.32)次/min、(82.32±5.27)次/min、(86.21±5.38)次/min]、SBP[(79.53±5.37) mm Hg、(84.24±4.24) mm Hg、(88.84±5.41) mm Hg]、DBP [(46.11±6.35) mm Hg、(50.08±4.65) mm Hg、(54.52±5.37) mm Hg]明显高于对照组[(73.59±6.29)次/min、(77.07±6.58)次/min、(82.30±5.32)次/min]、[(72.22±5.43) mm Hg、(78.40±7.11) mm Hg、(83.83±5.64) mm Hg]、[(39.18±5.61) mm Hg、(44.65±5.17) mm Hg、(48.37±6.40) mm Hg],差异均有统计学意义(P<0.05)。结论 白噪声疗法联合动画视频应用于全身麻醉患儿,可维持患儿血流动力学稳定,有利于促进快速诱导,减少苏醒期躁动,减轻术中应激反应,缓解术后疼痛。展开更多
文摘The purpose of this paper is to explore the safe and effective dose of dexmedetomidin for the prevention of agitation and delirium during the awakening period for children undergoing general anesthesia. Samples of 989 cases are collected from children with comprehensive treatment of dental caries, and were randomly divided into four groups. Group A, group B and group C were intravenously at constant speed （60 mL/h）, 0.5 and 0.25 infusion with 1 μg/kg dexmedetomidine. Group D （control group） was intravenously saline at the same speed. The score of 5-point scale and the incidence of ED （emergency delirium） and EA （emergence agitation） in four groups were compared. Comparison of four groups of CHIPPS （children and infants postoperative pain） score, the amount of operation time and record seven halothane （TO）, time to stop cover drug withdrawal of laryngeal anesthesia （TM）, eye opening time （TE）, independent records of children at the time of ICU stay after anesthesia （TP）. Results show that there was no significant difference between the four groups （p 〉 0.05）, among which the TM in B, C groups was significantly higher than that in A, D groups （p 〈 0.05）. Group C was significantly higher than group B （p 〈 0.05）. There was no significant difference in TE and TP between the A, B, D groups （p 〉 0. 05）. TE in group C was significantly higher than that in groups A, D （p 〉 0. 05）. The TP of group C was significantly higher than that of groups A, D （p 〈 0.05）, but there was no significant difference between the B, C groups （p 〉 0.05）. The incidence rates of EA and ED in groups A and B were significantly lower than those in group D （p 〈 0.05）. Group C was significantly lower than group A （p 〈 0.05）. There was no significant difference between group C and group C （p 〉 0.05）. The CHIPPS score and sevoflurane dosage in groups A and B were significantly lower than those in group D （p 〈 0.05）. Group C was significantly lower than group A （p 〈 0.05）. There was no significant difference between group C （p 〉 0.05）. Conclusion： the dose of dexmetomidine 0.5 μg/kg in children with general anesthesia can prevent restlessness and delirium after operation.
文摘Objective: To compare and analyze the effect and safety of double tube laryngeal mask and endotracheal intubation general anesthesia in fast track anesthesia for limb orthopaedic surgery in children with cerebral palsy. Methods: 78 children with cerebral palsy undergoing limb orthopedic surgery were randomly divided into laryngeal mask group and intubation group, with 39 cases in each group. The perioperative hemodynamic indexes, anesthesia effect related indexes, anesthesia related complications or adverse reaction rates of the two groups were observed and compared between the two groups. Results: When the two groups of children entered the room, there was no significant difference in MAP and HR (P > 0.05);MAP and HR of children in the intubation group were higher than those in the laryngeal mask anesthesia group (P Conclusion: Laryngeal mask is used to establish the airway of intravenous general anesthesia in limb orthopaedic surgery of children with cerebral palsy, which is conducive to the stability of children’s circulatory and respiratory system, to reduce the impact of narcotic drugs on children, to reduce the incidence of postoperative anesthesia related complications, and to improve the anesthetic effect. It meets the requirements of fast track anesthesia, and can be widely used in clinical practice.
文摘目的 观察白噪声疗法联合动画视频应用于全身麻醉患儿的临床效果。方法 根据随机数表法,将2020年3月至2023年1月期间河南省儿童医院麻醉与围术期医学科收治的81例拟行全身麻醉患儿分为对照组(n=40,全身麻醉期间接受常规干预)和研究组(n=41,全身麻醉期间接受白噪声疗法联合动画视频干预),比较两组手术前后的应激反应[皮质醇(Cor)、促肾上腺激素(ACTH)、去甲肾上腺素(NE)]、各项量表评分[全身麻醉苏醒期躁动风险量表(EA风险量表)、儿童疼痛行为量表(FLACC)、改良耶鲁术前焦虑量表(m-YPAS)、诱导期合作量表(ICC)、照护者心理弹性量表(CD-RISC)]和血流动力学变化[心率(HR)、收缩压(SBP)、舒张压(DBP)]。结果 研究组患儿术后血清ACTH、Cor、NE水平分别为(96.48±7.39) pg/L、(21.46±2.74) pg/L、(386.32±30.08) ng/L,明显低于对照组的(104.28±8.18) pg/L、(28.06±3.69) pg/L、(422.68±33.46) ng/L,差异均有统计学意义(P<0.05);术后,研究组患儿的EA风险量表、m-YPAS、FLACC、ICC评分分别为(6.39±1.54)分、(32.27±3.42)分、(3.01±0.92)分、(2.49±0.58)分,明显低于对照组的(10.43±2.67)分、(41.04±4.36)分、(6.97±1.56)分、(4.55±0.63)分,CD-RISC评分为(86.94±5.24)分,明显高于对照组的(72.06±6.39)分,差异均有统计学意义(P<0.05);研究组患儿插管前(T1)、插管即刻(T2)、插管后5 min (T3)时间点的HR、SBP、DBP先下降后升高,且研究组患儿T1、T2、T3时间点的HR [(78.62±4.32)次/min、(82.32±5.27)次/min、(86.21±5.38)次/min]、SBP[(79.53±5.37) mm Hg、(84.24±4.24) mm Hg、(88.84±5.41) mm Hg]、DBP [(46.11±6.35) mm Hg、(50.08±4.65) mm Hg、(54.52±5.37) mm Hg]明显高于对照组[(73.59±6.29)次/min、(77.07±6.58)次/min、(82.30±5.32)次/min]、[(72.22±5.43) mm Hg、(78.40±7.11) mm Hg、(83.83±5.64) mm Hg]、[(39.18±5.61) mm Hg、(44.65±5.17) mm Hg、(48.37±6.40) mm Hg],差异均有统计学意义(P<0.05)。结论 白噪声疗法联合动画视频应用于全身麻醉患儿,可维持患儿血流动力学稳定,有利于促进快速诱导,减少苏醒期躁动,减轻术中应激反应,缓解术后疼痛。
