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目的:观察不同剂量芬太尼对小儿七氟醚麻醉苏醒期躁动的影响。方法:选择拟于七氟醚麻醉下行扁桃体切除术的患儿60例,年龄3~8岁,随机分为3组。F1组:气管插管前静脉给予1μg/kg的芬太尼,术中每隔30 min追加0.25μg/kg的芬太尼;F2组:气管插管前静脉给予2μg/kg的芬太尼,术中每隔30 min追加0.5μg/kg的芬太尼;C组:对照组,在上述相应时间点给予等量的生理盐水。术中七氟醚维持麻醉。记录各组手术时间、术毕自主呼吸恢复时间、拔管时间(术毕到拔管)和拔管时(T1)、拔管后5 min(T2)、10 min(T3)的躁动发生率以及小儿麻醉后躁动评分(PAED)。结果:F2组术毕自主呼吸恢复时间和拔管时间明显长于对照组与F1组(P<0.05);F1和F2组在各个时间点的躁动发生率及PAED评分均明显低于对照组(P<0.05)。结论:诱导时静注1μg/kg且于术中每隔30 min追加0.25μg/kg的芬太尼可明显降低小儿七氟醚麻醉后躁动的发生率及程度,且不明显增加拔管时间,有利于七氟醚麻醉后的平稳恢复。
OBJECTIVE: To observe the effect of different doses of fentanyl on restlessness of anesthesia in pediatric sevoflurane anesthesia. Methods: Sixty children with tonsillectomy scheduled for sevoflurane anesthesia were randomly divided into three groups. Group F1: Fentanyl (1μg / kg) was given in the anterior endotracheal intubation, and 0.25μg / kg of fentanyl was added every 30 minutes during operation. Group F2: fentanyl (2μg / kg) During the operation, 0.5μg / kg of fentanyl was added every 30 minutes. Group C: control group was given the same amount of normal saline at the above time points. Intraoperative sevoflurane to maintain anesthesia. Record the operation time of each group, spontaneous respiratory resuscitation time, extubation time (extubation to surgery) and extubation (T1), extubation 5 min (T2), 10 min (T3) incidence of agitation and Pediatric Anesthesia Agitation Score (PAED). Results: The resuscitation time and extubation time of the F2 group were significantly longer than those of the control group and F1 group (P <0.05). The incidence of agitation and the PAED score of F1 and F2 group were significantly lower than those of the control group (P <0.05). CONCLUSION: Fentanyl with intravenous injection of 1μg / kg during induction and additional 0.25μg / kg every 30 minutes during operation can significantly reduce the incidence and extent of agitation after pediatric sevoflurane anesthesia without significantly increasing the extubation time, Is conducive to the steady recovery after sevoflurane anesthesia.