Bayrak Fatma, Gunday Isil, Memis Dilek, Turan Alparslan
Malatya Hospital, Malatya, Turkey.
J Opioid Manag. 2007 Mar-Apr;3(2):74-8. doi: 10.5055/jom.2007.0043.
This study was designed to evaluate the efficacy and safety of oral midazolam, tramadol drops, and intranasal sufentanil for premedication of pediatric patients.
Sixty children, three to 10 years of age, who were designated as American Society of Anesthesiologists physical status 1 and who were undergoing adenotonsillectomy as inpatients were randomized to receive a dosage of 0.5 mg/kg (total of 4 ml) midazolam in cherry juice (n=20, Group M), 3 mg/kg tramadol drops (n=20, Group T), or 2 microg/kg intranasal sufentanil (n=20, Group S). Clinical responses (sedation, anxiolysis, cooperation) and adverse effects (respiratory, hemodynamic, etc.) were recorded. Safety was assessed by continuous oxygen saturation monitoring and observation. Vital signs (blood pressure, pulse, oxygen saturation, respiratory rate) were recorded before drug administration (baseline) and then every 10 minutes until the induction of anesthesia.
Mean blood pressure decreased significantly after five minutes of intranasal sufentanil administration relative to Groups M (p < 0.01) and T (p < 0.05), whereas heart rate remained unchanged. Oxygen saturation and respiratory rate decreased significantly after 20 and 30 minutes of intranasal sufentanil administration relative to Groups M and T (p < 0.05). Anxiety scores showed rates of 45 percent in Group M, 5 percent in Group T, and 40 percent in Group S. Anxiety scores in Groups M and S were better than those of Group T (p < 0.01). Cooperation scores for face-mask acceptance showed rates of 85 percent in Group M, 45 percent in Group T, and 85 percent in Group S (p < 0.01).
Intranasal sufentanil and oral midazolam are more appropriate premedication options than tramadol drops in children.
本研究旨在评估口服咪达唑仑、曲马多滴剂和鼻内舒芬太尼用于小儿患者术前用药的有效性和安全性。
60名3至10岁的儿童，美国麻醉医师协会身体状况分级为1级，住院接受腺样体扁桃体切除术，随机分为三组，分别接受0.5mg/kg（共4ml）的咪达唑仑加樱桃汁（n = 20，M组）、3mg/kg曲马多滴剂（n = 20，T组）或2μg/kg鼻内舒芬太尼（n = 20，S组）。记录临床反应（镇静、抗焦虑、合作情况）和不良反应（呼吸、血流动力学等）。通过持续监测血氧饱和度和观察来评估安全性。在给药前（基线）记录生命体征（血压、脉搏、血氧饱和度、呼吸频率），然后每10分钟记录一次，直至诱导麻醉。
与M组（p < 0.01）和T组（p < 0.05）相比，鼻内给予舒芬太尼5分钟后平均血压显著下降，而心率保持不变。与M组和T组相比，鼻内给予舒芬太尼20和30分钟后血氧饱和度和呼吸频率显著下降（p < 0.05）。焦虑评分显示，M组为45%，T组为5%，S组为40%。M组和S组的焦虑评分优于T组（p < 0.01）。面罩接受度的合作评分显示，M组为85%，T组为45%，S组为85%（p < 0.01）。
对于儿童，鼻内舒芬太尼和口服咪达唑仑比曲马多滴剂更适合作为术前用药选择。
