Abu-Shahwan Ibrahim, Chowdary Khalid
Department of Anesthesiology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Paediatr Anaesth. 2007 Sep;17(9):846-50. doi: 10.1111/j.1460-9592.2007.02298.x.
Emergence agitation or delirium is a known phenomenon that may occur in children undergoing general anesthesia with inhaled agents. Our aim was to test the hypothesis that the addition of a small dose of ketamine at the end of sevoflurane anesthesia will result in a decrease in the incidence and severity of such phenomenon.
We performed a randomized double blind study involving 85 premedicated children 4-7 years old undergoing dental repair. Children were premedicated with acetaminophen and midazolam. Anesthesia was induced and maintained with sevoflurane in N2O/O2. Group K received ketamine 0.25 mg.kg (-1) and Group S received saline. We evaluated recovery characteristics upon awakening and during the first 30 min using the Pediatric Anesthesia Emergence Delirium scale.
Eighty of the 85 enrolled children completed the study. There were 42 children in Group I. Emergence agitation was diagnosed in seven children in the ketamine group (16.6%) and in 13 children in the placebo group (34.2%). There was no difference in time to meet recovery room discharge criteria between the two groups.
We conclude that the addition of ketamine 0.25 mg.kg(-1) can decrease the incidence of emergence agitation in children after sevoflurane general anesthesia.
苏醒期躁动或谵妄是一种已知现象，可能发生在接受吸入性麻醉剂全身麻醉的儿童中。我们的目的是检验在七氟醚麻醉结束时添加小剂量氯胺酮会降低这种现象的发生率和严重程度这一假设。
我们进行了一项随机双盲研究，纳入了85名4至7岁接受牙科修复且已进行术前用药的儿童。儿童术前使用对乙酰氨基酚和咪达唑仑。麻醉诱导和维持采用七氟醚加笑气/氧气。K组接受0.25mg/kg氯胺酮，S组接受生理盐水。我们使用小儿麻醉苏醒期谵妄量表评估苏醒时及最初30分钟内的恢复特征。
85名入组儿童中有80名完成了研究。I组有42名儿童。氯胺酮组有7名儿童（16.6%）被诊断为苏醒期躁动，安慰剂组有13名儿童（34.2%）。两组达到恢复室出院标准的时间没有差异。
我们得出结论，在七氟醚全身麻醉后添加0.25mg/kg氯胺酮可降低儿童苏醒期躁动的发生率。
