Chiba Satoko, Shima Takeshi, Murakami Noritaka, Kato Masato
Division of Anesthesia, Japanese Red Cross Sendai Hospital, Sendai 980-8501.
Masui. 2003 Jun;52(6):611-5.
Sevoflurane may be associated with a high incidence of agitation during recovery from anesthesia in children. We tested the hypothesis that bolus administration of propofol after sevoflurane anesthesia would reduce the incidence of recovery agitation compared with sevoflurane anesthesia alone.
We conducted a randomized, double-blinded study in 90 children, 1-7 yr of age, undergoing short general anesthesia. They were divided into three groups; 2 mg.kg-1 propofol (group P2), 1 mg.kg-1 propofol (group P1) and intralipid 0.2 ml.kg-1 as control (group C). After sevoflurane induction and maintenance and 5 minutes before the end of operation, propofol or intralipid was administered. We compared the speed and quality of each recovery. We made a new scoring system for the assessment of agitation. Each child received a point from -4 to 10 with this system.
Recovery score was similar among the three groups (group P2 had point 4, group P1, point 5, and group C point 4). Recovery time in group P2 was significantly longer than that in group C (about 6 minutes).
Bolus administration of propofol after sevoflurane anesthesia prolonged recovery time, but did not inhibit sevoflurane agitation compared with sevoflurane anesthesia alone.
七氟醚可能与儿童麻醉苏醒期躁动的高发生率有关。我们检验了这样一个假设:与单纯七氟醚麻醉相比,七氟醚麻醉后推注丙泊酚可降低苏醒期躁动的发生率。
我们对90名1至7岁接受短期全身麻醉的儿童进行了一项随机双盲研究。他们被分为三组;2mg·kg-1丙泊酚(P2组)、1mg·kg-1丙泊酚(P1组)和0.2ml·kg-1脂质乳剂作为对照组(C组)。在七氟醚诱导和维持麻醉后且手术结束前5分钟,给予丙泊酚或脂质乳剂。我们比较了各组苏醒的速度和质量。我们制定了一个新的评分系统来评估躁动情况。每个孩子在这个系统中得到一个从-4到10的分数。
三组的苏醒评分相似(P2组得分为4分,P1组得分为5分,C组得分为4分)。P2组的苏醒时间明显长于C组(约6分钟)。
与单纯七氟醚麻醉相比,七氟醚麻醉后推注丙泊酚延长了苏醒时间,但并未抑制七氟醚引起的躁动。