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目的:探究舒芬太尼与曲马多对用于小儿鼾症手术苏醒期躁动的作用与影响。方法:60例ASAⅠ或Ⅱ级扁桃体肥大或腺样体肥大的鼾症手术患儿,年龄6-14岁,无呼吸系统,循环系统等疾病,一般状态良好。随机分为舒芬太尼组(S组)和曲马多(T组),每组各30例。常规监测各项生命体征。于手术结束前20分钟(min),S组缓慢静脉输入0.15μg/kg舒芬太尼,T组静脉输入1-2mg/kg曲马多。观察各组的:平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2),进行各组的镇静评分(RSS)、躁动评分(RS)、镇痛评分(VRS)、意识状态评分(OAAS)。记录拔管前(T0)、拔管时(T1)、拔管后5 min(T2)、拔管后10 min(T3)、拔管后20 min(T4)各时间点各参数的变化。记录各组的恶心呕吐、呼吸抑制、烦躁等的发生率。结果:SpO2各组间无显著差异。MAP,HR在各时间点的变化T组大于S组,P<0.05,有显著差异。T组在RS,RSS,VRS评分与S组有显著差异,P<0.05。结论:0.15μg/kg的舒芬太尼在小儿鼾症手术的苏醒期可以维持稳定的血流动力学,副作用小,镇痛效果良好,可以有效减少小儿苏醒期的躁动。
Objective: To investigate the effect of sufentanil and tramadol on restless agitation in children with snoring. Methods: Sixty children with ASA Ⅰ or Ⅱ tonsil hypertrophy or adenoid hypertrophy undergoing snoring were aged 6-14 years old without respiratory system and circulatory system diseases, and were generally in good condition. Randomly divided into sufentanil group (S group) and tramadol (T group), each group of 30 cases. Routine monitoring of vital signs. At 20 min before surgery, 0.15 μg / kg sufentanil was given intravenously in group S and 1-2 mg / kg tramadol was given intravenously in group T, respectively. The mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) of each group were observed. The sedation scores (RSS), restlessness score (RS), VRS, Score (OAAS). The changes of parameters at each time point (T0), extubation (T1), 5 min after extubation (T2), 10 min after extubation (T3) and 20 min after extubation (T4) were recorded. Record the incidence of nausea and vomiting, respiratory depression and irritability in each group. Results: There was no significant difference between SpO2 groups. The change of MAP and HR at each time point in T group was greater than that in S group, P <0.05, there was a significant difference. The score of RS, RSS and VRS in group T were significantly different from that in group S (P <0.05). CONCLUSIONS: Sufentanil 0.15μg / kg can maintain stable hemodynamics during the recovery period of pediatric snoring surgery. The side effects are small and the analgesic effect is good. It can effectively reduce the restlessness of children in wakefulness.