比较氯胺酮-右美托咪定与氯胺酮-丙泊酚对采用七氟醚麻醉进行腺扁桃体切除术的儿科患者出现躁动的影响

A. Aly, Mohamed Rifky, Adnan Adwibi, Khadeja M. Elhossieny
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引用次数: 0

摘要

背景 小儿出院躁动(PEA) 出院躁动(EA)是指全身麻醉术后早期恢复过程中出现的焦虑、易激惹、无目的性运动、惊跳和迷失方向的状态,会对患儿及其家人造成伤害,导致手术部位出血、家长不悦和焦虑。目的 通过使用氯胺酮-右美托咪定(KD)或氯胺酮-丙泊酚(KP),降低在七氟醚麻醉下接受腺扁桃体切除术的小儿出现出院躁动(EA)的发生率。患者和方法 在这项前瞻性随机对照临床试验中,63 名儿童被随机分配到三个规模相似的组别中的一个:C 组(对照组)(21 人)接受单次静脉注射 10 毫升 0.9%生理盐水;KD组(n=21),在手术结束前10分钟注射0.15毫克/千克氯胺酮和0.3微克/千克右美托咪定;KP组(n=21),在手术结束前10分钟注射0.15毫克/千克氯胺酮和0.5毫克/千克异丙酚。主要结果是麻醉后EA,采用小儿麻醉后出现躁动量表(PAED)评分进行评估,然后评估OPS和并发症。结果 各组之间在心率方面存在明显差异,对照组在拔管后立即、5 分钟、10 分钟和 15 分钟心率较快。与 KP 组和对照组相比,KD 组的拔管时间最长。三个研究组在 10、20、25、30、35、40、45、50、55 和 60 分钟时的 PAED 评分有明显差异。结论 在手术结束前 10 分钟给予氯胺酮(0.15 毫克/千克)和右美托咪定(0.3 微克/千克)联合用药比酮酚更有效地防止新出现的躁动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison between the effect of ketamine-dexmedetomidine versus ketamine-propofol on emergence agitation in pediatrics undergoing adenotonsillectomy by sevoflurane anesthesia
Background Pediatric Emergence Agitation (PEA) Emergence agitation (EA) is a state of anxiety, irritability, non-purposeful movement, thrashing, and disorientation during early recovery from general anesthesia. it can be harmful for the children and their family, causing bleeding at the surgical site, parental unhappiness, and anxiety. Aim To decrease the incidence of emergence agitation (EA) in pediatrics undergoing adenotonsillectomy under sevoflurane anesthesia, by using ketamine-dexmedetomidine (KD) or ketamine-propofol (KP). Patients and methods In this prospective randomised controlled clinical trial, 63 children were randomly assigned to one of three groups of similar size: group C (Control group) (n=21), who received a single intravenous bolus of 10 ml 0.9% normal saline; group KD (n=21), who received 0.15 mg/kg ketamine and 0.3 μg/kg dexmedetomidine; 10 min before the end of surgery, and group KP (n=21), who received 0.15 mg/kg ketamine and 0.5 mg/kg propofol, 10 min before the end of surgery. The primary outcome was the post anesthesia EA which was evaluated using the pediatric anesthesia emergence agitation scale (PAED) score out come was assessment of OPS and complications. Results There were significant difference between the groups regarding the heart rate which was faster in the control group immediately, 5, 10, and 15 min post extubation. In the KD group the extubation time was the longest compared with the KP group and the control group. The PAED scores were significantly different among the three studied groups at 10, 20, 25, 30, 35, 40, 45, 50, 55, and 60 min. Conclusion The combination of ketamine (0.15 mg/kg) and dexmedetomidine (0.3 μg/kg) given 10 min before the completion of surgery was more effective in preventing emerging agitation than ketofol.
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