Kararmaz Alper, Kaya Sedat, Turhanoglu Selim, Ozyilmaz Mehmet Ali
Department of Anaesthesiology, Dicle University Hospital, Diyarbakir, Turkey.
Paediatr Anaesth. 2004 Jun;14(6):477-82. doi: 10.1111/j.1460-9592.2004.01224.x.
The purpose of the present study was to determine whether oral ketamine premedication affected the incidence of emergence agitation in children.
Thirty minutes before induction of anaesthesia, 80 children who were undergoing adenotonsillectomy with or without bilateral myringotomy and insertion of tubes received either ketamine 6 mg.kg(-1) per oral in group K or sour cherry juice alone in group C. Anaesthesia was maintained with desflurane. Emergence and recovery times were recorded. Tramadol was used for postoperative analgesia. Fentanyl (1 microg.kg(-1)) was administered for the treatment of emergence agitation or severe pain that still continued after tramadol administration. Postoperative behaviour was evaluated using a 5-point agitation scale.
The incidence of emergence agitation was 56% in group C, and 18% in group K (P = 0.001). There was no significant difference with respect to emergence times except from time to eye opening that was significantly longer in group K (P < 0.0001).
Oral ketamine premedication reduced the incidence of postanaesthesia emergence agitation in children without delaying recovery.
本研究旨在确定口服氯胺酮预处理是否会影响儿童苏醒期躁动的发生率。
在麻醉诱导前30分钟,80例接受腺样体扁桃体切除术(伴或不伴双侧鼓膜切开置管)的儿童,K组口服6mg.kg⁻¹氯胺酮,C组仅口服酸樱桃汁。麻醉维持采用地氟醚。记录苏醒和恢复时间。曲马多用于术后镇痛。给予芬太尼(1μg.kg⁻¹)治疗苏醒期躁动或曲马多给药后仍持续的重度疼痛。采用5分躁动量表评估术后行为。
C组苏醒期躁动发生率为56%,K组为18%(P = 0.001)。除睁眼时间K组明显更长(P < 0.0001)外,苏醒时间无显著差异。
口服氯胺酮预处理可降低儿童麻醉后苏醒期躁动的发生率,且不延迟恢复。