上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (1): 73-.

• 论著（临床研究） • 上一篇    下一篇

曲马多复合小剂量丙泊酚对小儿七氟醚麻醉术后躁动的影响

孙 瑛, 许文音, 胡 洁, 许文妍, 白 洁, 张马忠   

  1. 上海交通大学 医学院上海儿童医学中心麻醉科, 上海 200127
  • 出版日期:2010-01-26 发布日期:2010-01-26
  • 通讯作者: 张马忠, 电子信箱: doctorzmz@tom.com。
  • 作者简介:孙 瑛（1970—）, 女, 副主任医师, 博士, 硕士生导师；电子信箱: yingsun821@yahoo.com.cn。
  • 基金资助:

    上海市卫生局课题（2007057）

Combination effect of tramadol and low dose propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure

SUN Ying, XU Wen-yin, HU Jie, XU Wen-yan, BAI Jie, ZHANG Ma-zhong   

  1. Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
  • Online:2010-01-26 Published:2010-01-26
  • Supported by:

    Shanghai Municipal Health Bureau Foundation, 2007057

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摘要：

目的 研究曲马多复合小剂量丙泊酚对七氟醚麻醉患儿术后躁动的影响。方法 七氟醚诱导和维持麻醉下接受扁桃体切除术的患儿90例，根据手术结束前输注药物的不同分为对照组（手术结束前30 min注入0.1 mL/kg生理盐水）、曲马多组（手术结束前30 min注入1 mg/kg曲马多）和曲马多+丙泊酚组（手术结束前30 min注入1 mg/kg曲马多,联合手术结束即刻注入1 mg/kg丙泊酚）。记录各组术后拔管时间和麻醉恢复室(PACU)滞留时间，入PACU即刻进行小儿麻醉后躁动（PAED）评分、改良Aldrete评分和疼痛评分；观察术后恶心呕吐的发生情况。结果 各组间术后拔管时间、PACU滞留时间及改良Aldrete评分比较，差异均无统计学意义（P>0.05）。入PACU即刻的PAED评分为对照组>曲马多组>曲马多+丙泊酚组，组间比较差异均有统计学意义(P<0.05)；曲马多组和曲马多+丙泊酚组的疼痛评分明显低于对照组 (P<0.05)；恶心呕吐的发生率以曲马多组最高，曲马多+丙泊酚组显著低于曲马多组（P<0.05）。结论 曲马多复合小剂量丙泊酚可减少和减轻七氟醚麻醉下手术患儿的术后躁动，并降低应用曲马多所致恶心呕吐的发生率。

关键词: 七氟醚, 扁桃体切除术, 曲马多, 丙泊酚, 术后躁动, 小儿

Abstract:

Objective To investigate the combination effect of tramadol and low dose propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure. Methods Ninety patients receiving sevoflurane for adenotonsillectomy procedure were randomly divided into control group (administration of 0.1 mL/kg normal saline 30 min before the end of operation), tramadol group (administration of 1 mg/kg tramadol 30 min before the end of operation) and tramadol+propofol group (administration of 1 mg/kg tramadol 30 min before the end of operation and 1 mg/kg propofol at the end of operation). Time of extubation and time stayed in postanesthetic care unit (PACU) after operation were recorded, scores of Pediatric Anesthesia Emergence Delirium (PAED) Scale, modified Aldrete scores and pain scores were obtained immediately after entrance into PACU, and the prevalences of post-operative nausea and vomiting were observed. Results There was no significant difference in time of extubation, time stayed in PACU and modified Aldrete Scores among groups (P>0.05). There were significant differences in scores of PAED Scale immediately after entrance into PACU, with control group> tramadol group> tramadol+propofol group (P<0.05). The pain scores of tramadol group and tramadol+propofol group were significantly lower than that of control group (P<0.05). The prevalence of nausea and vomiting was the highest in tramadol group, and the prevalence in tramadol+propofol group was significantly lower than that in tramadol group (P<0.05). Conclusion The combination use of tramadol and low dose propofol can decrease the severity of emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure, and reduce the prevalence of nausea and vomiting.

Key words: sevoflurane, adenotonsillectomy, tramadol, propofol, emergence agitation, children