低剂量艾司洛尔在小儿外科手术全身麻醉中的应用
[Application of low-dose esmolamine in general anesthesia in pediatric surgeries].
作者信息
Chen Q, Liao Y, Li Z
机构信息
Department of Anesthesiology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen 361000, China.
Department of Anesthesiology, Xiang'an Hospital of Xiamen University, Xiamen 361005, China.
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2022 Oct 20;42(10):1584-1586. doi: 10.12122/j.issn.1673-4254.2022.10.21.
OBJECTIVE
To explore the effect of continuous low-dose infusion of esmolamine on intraoperative dosage of opioids and awakening quality in general anesthesia in pediatric surgeries.
METHODS
A total of 100 children (6-8 years of age) undergoing pediatric surgery under general anesthesia were randomized equally into observation group and control group.In the observation group, the children received an intravenous injection of 0.1mg/kg esmolamine 10 min before induction of general anesthesia, followed by intravenous infusion of esmolamine at 2 μg•kg•min until the end of the operation; those in the control group were infused with the same volume of normal saline instead of esmolamine in the same manner.The dosage of remifentanil during operation, recovery time of spontaneous breathing, recovery time of consciousness and extubation time were recorded in all the cases.The VAS score at 15, 30 and 60 min after extubation were assessed, and intravenous injection of naborphine 0.3 mg/kg was given for a VAS score ≥4;the total dosage of naborphine and adverse events were recorded for all the patients.
RESULTS
The total dose of remifentanil was significantly lower in the observation group than in the control group, but the spontaneous respiratory recovery time, consciousness recovery time and extubation time did not differ significantly between the two groups.The VAS scores at 15, 30 and 60 min after extubation were all better in the observation group than in the control group; the total intraoperative dose of naborphine was significantly lower in the observation group.
CONCLUSION
Continuous infusion of low-dose esmolamine during pediatric surgery can effectively lower intraoperative dosage of opioids and reduce pain during recovery without affecting the quality of awakening.
目的
探讨持续小剂量输注艾司洛尔对小儿外科全身麻醉中阿片类药物术中用量及苏醒质量的影响。
方法
选取100例6 - 8岁行全身麻醉下小儿外科手术的患儿，随机均分为观察组和对照组。观察组患儿在全身麻醉诱导前10分钟静脉注射0.1mg/kg艾司洛尔，随后以2μg•kg•min的速度静脉输注艾司洛尔直至手术结束；对照组患儿以同样方式输注等体积的生理盐水替代艾司洛尔。记录所有病例术中瑞芬太尼用量、自主呼吸恢复时间、意识恢复时间及拔管时间。评估拔管后15、30和60分钟的视觉模拟评分（VAS），VAS评分≥4分时静脉注射0.3mg/kg纳布啡；记录所有患者纳布啡总用量及不良事件。
结果
观察组瑞芬太尼总用量显著低于对照组，但两组自主呼吸恢复时间、意识恢复时间及拔管时间差异无统计学意义。观察组拔管后15、30和60分钟的VAS评分均优于对照组；观察组术中纳布啡总用量显著低于对照组。
结论
小儿外科手术中持续输注小剂量艾司洛尔可有效降低术中阿片类药物用量，减轻苏醒期疼痛，且不影响苏醒质量。
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