Sahmeddini Mohammad Ali, Panah Ashkan, Ghanbari Alireza
Anesthesiology, Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IRN.
Cureus. 2020 Apr 26;12(4):e7842. doi: 10.7759/cureus.7842.
Introduction Coughing is commonly observed during emergence from general anesthesia. In children, smooth emergence from anesthesia, especially after tonsillectomy, is crucial. In this study, we compared the effect of low-dose ketamine or propofol on emergence coughing in children undergoing tonsillectomy. Methods In this randomized clinical trial, 90 children undergoing tonsillectomy were randomly allocated into two groups: children in group A received 0.5-mg/kg propofol and children in group B received 0.5-mg/kg ketamine, at the end of anesthesia. The incidence and severity of cough, postoperative sedation, nausea, and vomiting, and pain score were recorded and compared. Results The incidence of no cough at emergence from anesthesia was 82.2% in the propofol group and 15.5% in the ketamine group (P = 0.00). Children in the ketamine group exhibited postoperative pain but were more sedated compared with those in the propofol group (P > 0.05). The incidence of postoperative nausea and vomiting was lower in the propofol group (P < 0.05). Conclusions At the end of general anesthesia with isoflurane in children undergoing tonsillectomy, 0.5-mg/kg propofol is more effective than 0.5-mg/kg ketamine in reducing cough response upon emergence from anesthesia, with a lower incidence of nausea and vomiting, as well as lower sedation in children.
引言 全身麻醉苏醒期咳嗽较为常见。对于儿童而言，麻醉平稳苏醒，尤其是扁桃体切除术后的平稳苏醒至关重要。在本研究中，我们比较了低剂量氯胺酮或丙泊酚对扁桃体切除术患儿苏醒期咳嗽的影响。
方法 在这项随机临床试验中，90例接受扁桃体切除术的患儿被随机分为两组：A组患儿在麻醉结束时接受0.5mg/kg丙泊酚，B组患儿接受0.5mg/kg氯胺酮。记录并比较咳嗽的发生率和严重程度、术后镇静情况、恶心和呕吐情况以及疼痛评分。
结果 丙泊酚组麻醉苏醒期无咳嗽的发生率为82.2%，氯胺酮组为15.5%（P = 0.00）。氯胺酮组患儿术后有疼痛，但与丙泊酚组患儿相比镇静程度更高（P > 0.05）。丙泊酚组术后恶心和呕吐的发生率较低（P < 0.05）。
结论 在接受扁桃体切除术的儿童异氟烷全身麻醉结束时，0.5mg/kg丙泊酚在减轻麻醉苏醒期咳嗽反应方面比0.5mg/kg氯胺酮更有效，恶心和呕吐的发生率更低，患儿的镇静程度也更低。
