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目的:观察预防应用地佐辛对口咽部手术患儿七氟醚吸入麻醉苏醒期Riker评分、可抚慰性(FLACC)评分、躁动发生率的影响,探讨其改善苏醒期质量的效果。方法:选择ASAⅠ-Ⅱ级择期在七氟醚吸入麻醉下行扁桃体摘除术的患儿60例,年龄4-10岁,体重13-34kg,采用随机数字表法,将其分为对照组和观察组,每组30例。两组麻醉诱导后行气管插管,机械通气,麻醉维持:吸入七氟醚2%-4%,静脉持续泵注瑞芬太尼0.5μg/(kg·min),手术结束前约20min对照组静脉滴注生理盐水,观察组静脉滴注地佐辛0.1mg/kg。观察并记录两组患儿麻醉诱导前(T0)、手术结束时(T1)、气管导管拔除时(T2)、气管导管拔除后5,10 min(T3,T4)时的平均动脉压(MAP)、心率(HR)。观察并记录患儿有咽部吞咽反射时进行Riker镇静躁动评分,于拔除气管导管后20min时进行FLACC评分。结果:与对照组(Ⅰ组)比较,观察组(Ⅱ组)T2-4时MAP、HR、Riker镇静躁动评分、FLACC评分、躁动发生率下降,差异有统计学意义(P<0.05)。结论:预防性应用0.1mg/kg地佐辛可明显改善扁桃体切除手术患儿七氟醚吸入麻醉苏醒质量。
OBJECTIVE: To observe the effect of dezocine in preventing and treating rheumatoid arthritis during resuscitation anesthesia with sevoflurane on Riker score, soothing (FLACC) score and agitation rate in children with oropharyngeal surgery. Methods: Sixty ASAⅠ-Ⅱselected children with tonsillectomy undergoing sevoflurane anesthesia were randomly divided into control group and observation group , 30 cases in each group. Two groups of anesthesia induced tracheal intubation, mechanical ventilation, anesthesia maintenance: inhalation of sevoflurane 2% -4%, intravenous infusion of remifentanil 0.5μg / (kg · min), about 20min before the end of surgery in the control group Intravenous instillation of saline, the observation group intravenous dezocine 0.1mg / kg. The mean arterial pressure (MAP) at the time of anesthesia induction (T0), end of surgery (T1), endotracheal tube extubation (T2) and 5,10 min (T3 and T4) , Heart rate (HR). The Riker sedation agitation scores were observed and recorded in children with pharyngeal swallowing reflex, and FLACC score was taken at 20 minutes after removal of the endotracheal tube. Results: Compared with the control group (group Ⅰ), the MAP, HR and Riker sedation restlessness score, FLACC score and agitation rate decreased in T2-4 group in the observation group (Ⅱ) (P <0.05). Conclusion: Preventive 0.1 mg / kg dezocine can significantly improve the anesthesia recovery of sevoflurane in tonsillectomy patients.