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目的本实验旨在观察全身麻醉下羟考酮不同静注方案对患儿的影响。方法选择择期进行扁桃体、腺样体切除术3-6岁患儿120例,随机分为四组,每组30例。A组诱导时给予羟考酮0.1mg/kg;B组诱导时给予羟考酮0.2mg/kg;C组诱导时给予羟考酮0.3mg/kg;D组诱导时给予芬太尼5μg/kg;插管反应严重时追加瑞芬太尼0.1mg/kg。静脉诱导:丙泊酚3mg/kg、顺苯磺酸阿曲库铵0.1mg/kg,插入气管导管机械通气。分别记录患儿入室安静后5min(T0)、插管即刻(T1)的MAP、HR;拔管时间和拔管后的Sp O_2、RR。记录拔管时的躁动评分、术后1小时内意识状态警觉/镇静(OAA/S)评级、恶心、呕吐发生率及扁桃体术后出血程度。结果 A组T1与T0比较MAP、HR明显升高(P<0.01);B组、C组、D组T1与T0比较MAP、HR变化没有统计学差异(P>0.01)。与D组相比,C组拔管时间明显延长(P<0.01);与D组相比,A组、B组拔管时间没有统计学差异(P>0.01)。四组拔管后的Sp O_2、RR没有明显差异(P>0.01)。拔管后躁动评分,A组、B组、C组明显低于D组(P<0.01)。D组拔管后恶心、呕吐发生率明显高于A、B两组(P<0.01),与C组无明显差异。结论对于3~6岁接受扁桃体腺样体切除术的患儿,在诱导时给予0.2mg/kg的羟考酮是比较理想的注射方案。
Objective This experiment aimed to observe the effects of different intravenous oxycodone intravenous regimens on children under general anesthesia. Methods Elective tonsil, adenoidectomy in children aged 3-6 120 cases were randomly divided into four groups, 30 cases in each group. Oxycodone 0.1 mg / kg was induced in group A, Oxycodone 0.2 mg / kg was induced in group B, Oxycodone 0.3 mg / kg was induced in group C, while fentanyl 5 μg / kg ; Severe intubation remifentanil supplementation 0.1mg / kg. Intravenous induction: propofol 3mg / kg, atracurbate mesylate 0.1mg / kg, into the tracheal tube mechanical ventilation. The MAP, HR of the intubation immediately after the intubation (T0) and Sp O_2 and RR after the extubation were recorded respectively. The agitation scores during extubation, OAA / S rating within 1 hour after surgery, the incidence of nausea and vomiting, and the degree of postoperative tonsil bleeding were recorded. Results Compared with T0 in group A, MAP and HR were significantly increased (P <0.01). There was no significant difference between T1 and T0 in group B, C and D (P> 0.01). Compared with group D, the extubation time was significantly longer in group C (P <0.01). Compared with group D, the extubation time in group A and group B was not statistically different (P> 0.01). There were no significant differences in Sp O 2 and RR between the four groups after extubation (P> 0.01). After extubation agitation score, A group, B group, C group was significantly lower than D group (P <0.01). The incidence of nausea and vomiting after extubation in group D was significantly higher than that in groups A and B (P <0.01), but no significant difference with group C. Conclusions For children aged 3-6 years who underwent adenotonsillectomy, oxycodone 0.2 mg / kg was an ideal injection schedule at induction.