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目的评估地佐辛预防小儿七氟醚复合麻醉下人工耳蜗植入术后躁动的有效性及安全性。方法将40例ASA分为Ⅰ级或Ⅱ级、拟行人工耳蜗植入术的患儿随机分为生理盐水组(A组)和地佐辛组(B组)。采用吸入七氟醚、静脉注射芬太尼及顺苯磺酸阿曲库铵行麻醉诱导;术中七氟醚复合瑞芬太尼维持麻醉。手术结束前15分钟,B组和A组患儿分别注射地佐辛0.05mg/kg和等容量生理盐水。记录手术时间、麻醉时间、麻醉结束至拔管时间和麻醉恢复室滞留时间。分别采用儿童疼痛观察量表(POCIS)和麻醉苏醒期躁动量化评分表(PAED)评价并记录入麻醉恢复室即刻(T0)、15分钟(T1)和30分钟(T2)的疼痛和躁动程度,并观察术后6小时内不良反应的发生情况。结果与A组比较,B组患儿T0、T1的PAED评分明显降低,T0、T1和13的P0-CIS评分明显降低,差异有统计学意义(P<0.05)。结论地佐辛能降低七氟醚复合麻醉手术后躁动程度,可安全应用于人工耳蜗植入术住院手术患儿。
Objective To evaluate the efficacy and safety of dezocine in preventing post-cochlear implants in pediatric sevoflurane anesthesia. Methods Forty patients with ASA were divided into grade I and grade II. The children undergoing cochlear implantation were randomly divided into saline group (group A) and dezocine group (group B). Induction of anesthesia was induced by inhalation of sevoflurane, intravenous injection of fentanyl and atracurium citrate sulphate. Intraoperative sevoflurane and remifentanil were anesthetized. Fifteen minutes prior to the end of surgery, children in group B and group A received dezocine 0.05 mg / kg and an equal volume of saline, respectively. The operation time, anesthesia time, anesthesia end to extubation time and anesthesia recovery room retention time were recorded. The severity of pain and agitation were evaluated by POCIS and PAED at the moment of anesthesia recovery (T0), 15 minutes (T1) and 30 minutes (T2), respectively. And observe the occurrence of adverse reactions within 6 hours after operation. Results Compared with group A, the PAED scores of T0 and T1 in group B were significantly lower than those in group A, P0-CIS scores of T0, T1 and 13 were significantly lower (P <0.05). Conclusion Dezocine can reduce the degree of restlessness after sevoflurane anesthesia and can be safely applied to children undergoing cochlear implant surgery.