›› 2009, Vol. 29 ›› Issue (7): 842-.

• 论著(临床研究) • 上一篇    下一篇

双氯芬酸钠栓对扁桃体切除术患儿七氟醚麻醉术后躁动的影响

孙 瑛, 许文音, 胡 洁, 王燕婷, 白 洁   

  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:2009-07-25 发布日期:2009-09-16
  • 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)

Effects of diclofenac sodium suppositories on emergence agitation after sevoflurane maintenance in children undergoing adenotonsillectomy

SUN Ying, XU Wen-yin, HU Jie, WANG Yan-ting, BAI Jie   

  1. Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
  • Online:2009-07-25 Published:2009-09-16
  • Supported by:

    Shanghai Municipal Health Bureau Foundation, 2007057

摘要:

目的 通过双氯芬酸钠栓在行扁桃体切除和腺样体吸割患儿的应用,观察其对术后躁动发生的影响。方法 45例择期行扁桃体切除和腺样体吸割患儿随机分为三组,每组15例。组1在手术前气管插管后即刻给予双氯芬酸钠栓12.5 mg,组2在手术结束即刻给予双氯芬酸钠栓12.5 mg,对照组手术前后均不给予双氯芬酸钠栓。记录所有患儿的拔管时间和恢复室滞留时间;进入恢复室后进行改良Aldrete评分和疼痛评分;于入恢复室后10、20、30 min分别进行儿童麻醉后躁动(PAED)评分。结果 各组拔管时间和恢复室滞留时间比较,差异无统计学意义(P>0.05)。入恢复室后10 min,组1的PAED评分显著低于组2和对照组(P<0.05),而后两组组间比较差异无统计学意义(P>0.05)。入恢复室后20和30 min,组1和组2的PAED评分显著低于对照组(P<0.05)。三组入恢复室即刻的改良Aldrete评分比较差异无统计学意义。组1和组2的疼痛评分显著低于对照组(P<0.05)。结论 双氯芬酸钠的应用一定程度上可以减少患儿麻醉术后躁动的发生。

关键词: 七氟醚, 扁桃体腺样体切除, 双氯芬酸纳栓, 术后躁动, 儿童

Abstract:

Objective To investigate the effects of diclofenac sodium suppositories on emergence agitation after sevoflurane maintenance in children undergoing adenotonsillectomy. Methods Forty-five patients selected for adenotonsillectomy were randomly divided into three groups (n=15). Patients in group 1 were given diclofenac sodium suppositories 12.5 mg right after intubation, those in group 2 were given diclofenac sodium suppositories 12.5 mg immediately after operation, while those in control group were not treated with diclofenac sodium suppositories before or after operation. The extubation time and time spent in post-anesthctic ICU (PACU) were recorded, the modified Aldrete score and pain score were assessed after entrance into PACU, and pediatric anesthesia emergence delirium (PAED) scale was administered 10, 20 and 30 min after entrance into PACU. Results There was no significant difference in extubation time and time spent in PACU among three groups(P>0.05). Ten minutes after entrance into PACU, the PAED score of group 1 was significantly lower than those of group 2 and control group(P<0.05), while there was no significant difference between the latter two groups(P>0.05). Twenty and thirty minutes after entrance into PACU, the PAED scores of group 1 and group 2 were significantly lower than that of control group(P<0.05). There was no significant difference in the modified Aldrete score right after entrance into PACU among three groups. The pain scores of group 1 and group 2 were signifiantly lower than that of control group(P<0.05). Conclusion Diclofenac sodium suppositories can decrease the incidence and severity of emergence agitation after sevoflurane maintenance in children undergoing adenotonsillectomy.

Key words: sevoflurane, adenotonsillectomy, diclofenac sodium suppositories, postoperative delirium, children