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目的研究酮咯酸氨丁三醇对儿童患者全身麻醉下扁桃体切除术中芬太尼用量的节俭作用。方法择期气管内插管全麻下行扁桃体切除术儿童40例,年龄4-8岁,按住院号奇偶数分为两组:酮咯酸氨丁三醇组和芬太尼组,每组20例。两组患儿的麻醉诱导均为静脉注射咪达唑仑0.1 mg/kg、芬太尼0.005 mg/kg、丙泊酚2 mg/kg、顺式阿曲库胺0.18 mg/kg。酮咯酸氨丁三醇组气管插管完成后立即静脉注射酮咯酸氨丁三醇0.5 mg/kg,芬太尼组不注射酮咯酸氨丁三醇,两组术中均采用静吸复合麻醉。记录入室后平均动脉压(MAP)与心率(HR)、切扁桃体时的MAP与HR、术中出血量、输液量、术毕芬太尼用量及苏醒期躁动情况。结果两组患儿的年龄、性别、体重、入室MAP、HR、术中出血量及术中补液量比较差异无统计学意义(P>0.05);两组患儿切除扁桃体时的MAP差异无统计学意义(P>0.05),但芬太尼组的HR明显高于酮咯酸氨丁三醇组(P<0.05);术毕芬太尼组的芬太尼消耗量高于酮咯酸氨丁三醇组(P<0.05);两组患儿苏醒期躁动评分差异无统计学意义(P>0.05)。结论儿童患者在全身麻醉下行扁桃体切除术中应用酮咯酸氨丁三醇能够明显减少芬太尼的用量且不增加患儿苏醒期的躁动。
Objective To study the thrift effect of ketorolac trometamol on the dosage of fentanyl in tonsillectomy under general anesthesia in children. Methods Elective endotracheal intubation under general anesthesia 40 tonsillectomy children, aged 4-8 years old, according to the number of hospitalized patients were divided into two groups: ketorolac tromethamine group and fentanyl group, 20 cases in each group . Induction of anesthesia in both groups was intravenous midazolam 0.1 mg / kg, fentanyl 0.005 mg / kg, propofol 2 mg / kg, cisatracurium 0.18 mg / kg. Ketorolac tromethamine group immediately after tracheal intubation ketorolac tromethamine 0.5 mg / kg, fentanyl group did not inject ketorolac tromethamine, both groups were used during surgery Compound anesthesia. Mean arterial pressure (MAP) and heart rate (HR) after admission, MAP and HR at the time of tonsillectomy, intraoperative blood loss, fluid volume, the amount of fentanyl and recovery of restlessness were recorded. Results There was no significant difference in age, sex, body weight, MAP, HR, intraoperative blood loss and intraoperative fluid volume between the two groups (P> 0.05). There was no statistical difference in MAP between the two groups (P> 0.05), but the HR in fentanyl group was significantly higher than that in ketorolac tromethamine group (P <0.05). The consumption of fentanyl in fentanyl group was higher than that of ketorolac ammonia (P <0.05). There was no significant difference in restlessness agitation score between the two groups (P> 0.05). Conclusion The application of ketorolac tromethamine in children under general anesthesia during tonsillectomy can significantly reduce the dosage of fentanyl and does not increase the restlessness in children.