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目的探讨酮咯酸氨丁三醇预防性给药对小儿全身麻醉术后应激反应的影响。方法选取2013年12月至2014年8月于沧州市人民医院进行全身麻醉手术的小儿患者76例,按抽签法随机分为观察组和对照组,每组38例。观察组患儿全身麻醉插管前给予酮咯酸氨丁三醇,对照组患儿注射等量0.9%氯化钠注射液,观察两组患儿手术前(T_1)、拔管即刻(T_2)、拔管后10 min(T_3)、拔管后20 min(T_4)的平均动脉压(MAP)及心率(HR)变化,以及术后不良反应发生情况。结果观察组患儿T_2、T_3、T_4时点的MAP分别为(98±8)mm Hg、(83±6)mm Hg、(79±5)mm Hg,HR分别为(115±11)次/min、(106±11)次/min、(98±11)次/min均低于对照组相应指标,差异均有统计学意义(P<0.05);观察组患儿T_2、T_3、T_4时点的血糖和血浆皮质醇含量均低于对照组,差异均有统计学意义(P<0.05);观察组患儿恶心呕吐、躁动和低血氧的发生率为26.3%,显著低于对照组的52.6%,差异有统计学意义(P<0.05)。结论全身麻醉手术插管前对全身麻醉患儿注射适量酮咯酸氨丁三醇,可以减轻其术后心血管应激反应程度,降低不良反应发生率。
Objective To investigate the effect of ketorolac trometamol prophylaxis on stress response in children under general anesthesia. Methods Totally 76 pediatric patients undergoing general anesthesia in Cangzhou People’s Hospital from December 2013 to August 2014 were randomly divided into observation group and control group according to random selection method, with 38 cases in each group. Patients in the observation group were given ketorolac tromethamine before general anesthesia intubation and 0.9% sodium chloride injection in the control group. The levels of T_1, T_2, , Mean arterial pressure (MAP) and heart rate (HR) at 10 min after extubation (T 3) and 20 min after extubation (T 4), as well as the incidence of postoperative adverse reactions. Results The MAP of T 2, T 3 and T 4 in the observation group were (98 ± 8) mm Hg, (83 ± 6) mm Hg, and (79 ± 5) mm Hg, respectively. min, (106 ± 11) times / min and (98 ± 11) times / min, respectively, which were significantly lower than those in the control group (P <0.05). The levels of T 2, T 3 and T 4 in the observation group (P <0.05). The incidence of nausea and vomiting, restlessness and hypoxemia in the observation group was significantly lower than that in the control group (26.3%), and the blood glucose and plasma cortisol levels in the observation group were significantly lower than those in the control group 52.6%, the difference was statistically significant (P <0.05). Conclusion Before intubation of general anesthesia for general anesthesia, injection of ketorolac tromethamine can reduce the postoperative cardiovascular response and reduce the incidence of adverse reactions.