论文部分内容阅读
目的探讨在小儿扁桃体联合腺样体切除术前静注氟比洛芬酯超前镇痛的安全性、有效性及最佳剂量。方法 60例择期行扁桃体联合腺样体切除术患儿随机均分为三组,分别在麻醉诱导时静注生理盐水10ml(F0)、氟比洛芬酯1mg/kg(F1组)、氟比洛芬酯1.5mg/kg(F2组)。观察术中及术后0.5、1、4、8、12、24h(T1-6)的HR、MAP、RR、SPO2,术后各时间点的VASF评分值及不良反应。结果三组术中HR、MAP和术后RR、SpO2均无显著差异。F1组MAP、HR在T1、T2低于F0组(P<0.05);F2组MAP、HR在T1-3低于F0组而HR在T4仍低于F0组(P<0.05);F1组与F2组间比较无显著性差异。术后VASF评分三组患儿在4h以内最高,以后呈下降趋势;F1组在T1-3显著低于F0组(P<0.01,P<0.05);F2组T1-3和T4、T5显著低于F0组(P<0.01,P<0.05),在T1-4低于F1组(P<0.05)。术后躁动发生率F0组为50%,F2组显著低于F0、F1组(P<0.01,P<0.05);F2组拔管后哭闹的发生率低于F0组(P<0.05)。结论小儿扁桃体联合腺样体切除术前静注氟比洛芬酯1-1.5mg/kg均可产生良好的超前镇痛效果,不良反应少,1.5mg/kg效果更优。
Objective To investigate the safety, efficacy and optimal dose of flurbiprofen axetil prednisolone in pediatric tonsil combined adenoidectomy. Methods Sixty children with tonsillectomy and adenoidectomy were randomly divided into three groups randomly: normal saline (F0), flurbiprofen axetil 1 mg / kg (F1), fluoride ratio Lophenylacetone 1.5 mg / kg (F2 group). HR, MAP, RR, SPO2 at 0.5, 1, 4, 8, 12, 24 h (T1-6) and postoperative VASF scores and adverse reactions at each time point were observed. Results There were no significant differences in HR, MAP and postoperative RR, SpO2 among the three groups. MAP and HR in F1 group were lower than those in F0 group at T1 and T2 (P <0.05); HR and MAP in F2 group were lower than those in F0 group and HR group was still lower than F0 group at T4 (P <0.05) There was no significant difference between F2 groups. The postoperative VASF score of three groups was the highest in 4h, and then decreased. The level of T1-3 in F1 group was significantly lower than that in F0 group (P <0.01, P <0.05); T1-3 and T4, T5 in F2 group were significantly lower In F0 group (P <0.01, P <0.05), T1-4 was lower than F1 group (P <0.05). The incidence of postoperative agitation was 50% in F0 group, F2 group was significantly lower than that in F0 and F1 group (P <0.01, P <0.05). The incidence of crying after extubation in F2 group was lower than that in F0 group (P <0.05). Conclusions The pretreatment of flurbiprofen axetil 1-1.5mg / kg before pediatric tonsil combined with adenoidectomy can produce good analgesic effect with less adverse reactions, and the effect is better at 1.5mg / kg.