预防性使用纳布啡对接受七氟醚麻醉的耳鼻喉科手术小儿患者苏醒期躁动及术后疼痛的影响。
Effects of prophylactic nalbuphine on emergence agitation and postoperative pain in pediatric patients undergoing ENT surgery with sevoflurane anesthesia.
作者信息
Han Wendong, Cai Jingjie, Zhang Wangping, Wei Rong, Jiang Yan
机构信息
Department of Anesthesiology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Anesthesiology, Women and Children's Hospital of Jiaxing University, Jiaxing, China.
出版信息
Front Pediatr. 2024 Sep 17;12:1353027. doi: 10.3389/fped.2024.1353027. eCollection 2024.
BACKGROUND
Emergence agitation (EA) is a common complication in the pediatric population. This study aimed to investigate the effect of the prophylactic nalbuphine on EA in pediatric patients receiving sevoflurane anesthesia.
METHODS
The children undergoing ear, nose, and throat (ENT) surgery were administered 0.2 mg/kg nalbuphine (the nalbuphine group) or the same volume of normal saline (the control group) 5 min before the end of the surgery. The extubating time, time to eye-opening and duration of the post-anesthesia care unit (PACU) were recorded. Heart rate and blood pressure were monitored before and 5 min after nalbuphine administration. Pain was assessed using Face Legs Activity Cry and Consolability (FLACC) scales, and the drug-related postoperative complications (e.g., EA, delayed awakening, nausea and vomiting, and respiratory depression) were recorded.
RESULTS
One-hundred and thirty pediatric patients were randomly divided into nalbuphine and control groups ( = 65). The nalbuphine group showed a significantly lower incidence of EA than the control group (20% vs. 46.2%, = 0.002). No significant differences between the two groups were observed in heart rate and blood pressure 5 min after nalbuphine administration ( > 0.05). No significant differences were observed between the two groups regarding extubating time, time to eye-opening, and duration of PACU. The FLACC scales demonstrated lower values in the nalbuphine group than in the control group during the initial 4 h after the surgery. However, the FLACC scales showed similar values between 5 and 12 h after the surgery.
CONCLUSIONS
In summary, the results of this study demonstrated that prophylactic natbuphine could minimize the incidence of EA in pediatric patients following ENT surgery without increasing the extubating time and PACU duration.
CLINICAL TRIAL REGISTRATION
http://www.chictr.org.cn, identifier [ChiCTR2300070046].
背景
苏醒期躁动（EA）是儿科患者常见的并发症。本研究旨在探讨预防性使用纳布啡对接受七氟醚麻醉的儿科患者EA的影响。
方法
接受耳鼻喉（ENT）手术的儿童在手术结束前5分钟给予0.2mg/kg纳布啡（纳布啡组）或相同体积的生理盐水（对照组）。记录拔管时间、睁眼时间和麻醉后监护病房（PACU）停留时间。在给予纳布啡前及给药后5分钟监测心率和血压。使用面部表情、腿部活动、哭闹和可安慰性（FLACC）量表评估疼痛，并记录与药物相关的术后并发症（如EA、苏醒延迟、恶心呕吐和呼吸抑制）。
结果
130例儿科患者随机分为纳布啡组和对照组（每组65例）。纳布啡组的EA发生率显著低于对照组（20%对46.2%，P = 0.002）。给予纳布啡5分钟后，两组心率和血压无显著差异（P > 0.05）。两组在拔管时间、睁眼时间和PACU停留时间方面无显著差异。术后最初4小时内，纳布啡组的FLACC量表评分低于对照组。然而，术后5至12小时，两组FLACC量表评分相似。
结论
总之，本研究结果表明，预防性使用纳布啡可降低耳鼻喉手术后儿科患者EA的发生率，且不增加拔管时间和PACU停留时间。
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