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目的观察右美托咪啶和氯胺酮对腺样体、扁桃体切除患儿全麻苏醒期躁动的影响。方法选择于2014年2~12月在医院行全身麻醉下腺样体扁桃体切除术的患儿75例,随机分成A、B、C 3组各25例,A组为右美托咪定组,B组为小剂量氯胺酮组,C组为0.9%氯化钠溶液组,比较3组术后躁动、拔管后1~4h镇静评分等指标。结果A组术后躁动发生率较B、C组均低(P<0.05)。A、B组在拔管后1~4h的镇静评分高于C组(P<0.05)。A组术后平稳睡眠例数明显多于B组与C组,差异均有统计学意义(P<0.05)。结论右美托咪啶和氯胺酮均能够预防小儿苏醒期躁动,但右美托咪啶效果更佳。
Objective To observe the effects of dexmedetomidine and ketamine on agitation in awakening of general anesthesia in adenoid and tonsil children. Methods Seventy-five children with adenotonsillectomy under general anesthesia were randomly divided into A, B and C groups of 25 cases in each group from January to December in 2014. A group was dexmedetomidine group, Group B was a low-dose ketamine group, Group C was 0.9% sodium chloride solution group. The postoperative agitation and sedation score 1 ~ 4 h after extubation were compared. Results The incidence of postoperative agitation in group A was lower than that in group B and C (P <0.05). The sedation score of group A and group B at 1-4h after extubation was higher than that of group C (P <0.05). The number of postoperative stable sleep in group A was significantly more than that in group B and C (P <0.05). Conclusion Both dexmedetomidine and ketamine can prevent restlessness in children, but dexmedetomidine is more effective.