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目的:观察曲马多复合对乙酰氨基酚栓剂防治小儿七氟醚全麻苏醒期躁动的效果。方法:择期七氟醚全麻下手术患儿90例随机分为3组,每组各30例。3组均用8%七氟醚、芬太尼2μg/kg和维库溴铵0.1 mg/kg全麻诱导,术中以七氟醚(1~1.5 MAC)维持麻醉。A组:术前10 min对乙酰氨基酚栓剂20 mg/kg塞肛+手术结束前20 min静注曲马多1 mg/kg;B组:手术结束前20 min静注曲马多2 mg/kg;C组:手术结束前20 min静注等量生理盐水。观察3组手术时间,术后清醒时间、拔管时间、镇静评分、躁动发生情况及药物不良反应。结果:3组手术时间、清醒时间、拔管时间等指标比较,差异无统计学意义(P>0.05)。A组躁动发生率、恶心呕吐发生率和躁动评分明显低于B组和C组,而Remesay镇静评分明显高于B组和C组(P<0.05),结论:曲马多1 mg/kg复合对乙酰氨基酚栓剂20 mg/kg用于防治小儿七氟醚全麻苏醒期躁动安全有效。
OBJECTIVE: To observe the effect of tramadol combined with acetaminophen suppository in preventing and treating agitation in pediatric sevoflurane general anesthesia. Methods: Seventy children undergoing elective sevoflurane anesthesia were randomly divided into three groups (n = 30 in each group). All three groups were induced with 8% sevoflurane, fentanyl 2 μg / kg and vecuronium 0.1 mg / kg general anesthesia. Intraoperative sevoflurane (1-1.5 MAC) was used to maintain anesthesia. Group A: paracetamol suppositories 20 mg / kg 10 min before operation + tramadol 1 mg / kg 20 min before the end of operation; Group B: tramadol 2 mg / kg; Group C: the same amount of normal saline was intravenously injected 20 minutes before the end of surgery. The operation time, postoperative awake time, extubation time, sedation score, restlessness and adverse drug reactions were observed. Results: The operation time, awake time and extubation time of the three groups showed no significant difference (P> 0.05). The incidence of agitation, nausea and vomiting and agitation in group A were significantly lower than those in groups B and C, while the Remesay sedation scores were significantly higher than those in groups B and C (P <0.05). Conclusion: The tramadol 1 mg / kg Acetaminophen suppository 20 mg / kg for the prevention and treatment of pediatric sevoflurane anesthesia wakefulness restless safe and effective.