不同剂量氯胺酮对七氟烷麻醉下小儿分离焦虑及苏醒期躁动的影响

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (1): 58-61.

不同剂量氯胺酮对七氟烷麻醉下小儿分离焦虑及苏醒期躁动的影响

夏菊荣, 杜忠举, 王波, 张华, 田洪忆

杭州市第三人民医院麻醉科,杭州310009,浙江

收稿日期:2013-01-17 修回日期:2013-07-15 出版日期:2014-01-27 发布日期:2014-02-12
作者简介:夏菊荣,男,副主任医师 ,主要研究方向:临床麻醉与慢性疼痛。Tel: 13858027030 E-mail: xiajurong@gmail.com

Effect of different doses of ketamine on separation anxiety and emergence agitation in pediatrics undergoing PCNL under sevoflurane general anesthesia

XIA Ju-rong,DU Zhong-ju,WANG Bo,ZHANG Hua ,TIAN Hong-yi

Department of Anesthesiology, the Third People's Hospital of Hangzhou, Hangzhou 310009 , Zhejiang, China

Received:2013-01-17 Revised:2013-07-15 Online:2014-01-27 Published:2014-02-12

摘要/Abstract

摘要： 目的: 探讨不同剂量氯胺酮对七氟烷麻醉下小儿分离焦虑及苏醒期躁动(Emergence agitation,EA)的影响。方法: 80名择期行经皮肾镜钬激光碎石术(PCNL)的2～8岁小儿随机分为4组:C组给予生理盐水,K0.5、K0.75、K1组分别在小儿入室前静注氯胺酮 0.5、0.75、1 mg/kg,4组患儿均接受常规七氟烷维持麻醉。评估各组小儿麻醉诱导前分离焦虑评分,记录小儿的拔管时间、麻醉后监测治疗室(PACU)停留时间、术后恶心呕吐、EA发生率及修正CHEOPS疼痛评分。结果: K0.75、K1组患儿术前分离焦虑评分明显低于K0.5 组及C组(P<0.05),K1组拔管时间及PACU停留时间明显长于其他3组(P<0.05),C组EA发生率和CHEOPS评分明显高于3个氯胺酮组(P<0.05),但3个氯胺酮组间差异无统计学意义(P>0.05)。结论: 0.75 mg/kg 氯胺酮入室前静注能减少小儿分离焦虑评分、术后疼痛评分及EA发生,且不影响拔管时间及PACU停留时间。

关键词: 苏醒期躁动, 小儿, 七氟烷, 氯胺酮, 分离焦虑

Abstract: AIM: To investigate the preventive effect of ketamine with different doses on separation anxiety and emergence agitation (EA) after sevoflurane anesthesia in children for PC- NL (percutaneous nephrolithotomy lithotripsy) surgery.METHODS: Eighty children, ranging in age from 2-8 years old, undergoing PCNL surgery were randomly allocated to one of the 4 groups: group C received normal saline, group K0.5, K0.75 and K1 received ketamine 0.5 mg/kg, 0.75 mg/kg or 1.0 mg/kg intravenously before entering the operating room respectively. Children in four groups received conventional sevoflurane for maintain anesthesia. The separation anxiety score before induction was evaluated. Extubation time, post-anesthesia care unit stay time, postoperative nausea and vomiting, emergence agitation, and pain (the modified Children's Hospital of Eastern Ontario Pain Scale,Modified CHEOPS) were assessed.RESULTS: The preoperative separation anxiety scores in group K0.75 and group K1 were significantly lower than those in group K0.5 and group C(P<0.05). Time of extubation and post-anesthesia care unit stay in group K1 was significantly lower than that three groups(P<0.05). The incidence of EA and Modified CHEOPS were significantly higher than those three-ketamine groups(P<0.05),but there was no statistically significant differences among three ketamine groups(P>0.05).CONCLUSION: Ketamine 0.75 mg/kg administered before entering the operating room reduced separation anxiety, postoperative pain and incidence of EA without delay in recovery.

Key words: Emergence agitation, Children, Sevoflurane, Ketamine, Separation anxiety

中图分类号:

R614

夏菊荣, 杜忠举, 王波, 张华, 田洪忆. 不同剂量氯胺酮对七氟烷麻醉下小儿分离焦虑及苏醒期躁动的影响[J]. 中国临床药理学与治疗学, 2014, 19(1): 58-61.

XIA Ju-rong,DU Zhong-ju,WANG Bo,ZHANG Hua ,TIAN Hong-yi. Effect of different doses of ketamine on separation anxiety and emergence agitation in pediatrics undergoing PCNL under sevoflurane general anesthesia[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(1): 58-61.

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