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咪达唑仑对小儿包皮环切术后苏醒期躁动及苏醒时间的影响

Effects of midazolam on the agitation and wake time of the postoperative resuscitation in pediatric circumcision

摘要:

目的 探讨咪达唑仑对小儿包皮环切术后苏醒期躁动和苏醒时间的影响.方法 回顾性分析170例行小儿包皮环切术治疗患儿的临床资料,根据麻醉方法不同分为对照组和观察组,每组85例.对照组采取七氟烷复合氯胺酮进行麻醉,观察组采取七氟烷、氯胺酮联合咪达唑仑进行麻醉,对比两组麻醉效果.结果 观察组手术开始10 min心率为(99.64±5.97)次/min,平均动脉压为(65.81±5.63)mmHg;对照组手术开始10 min心率为(122.38±12.54)次/min,平均动脉压为(86.49±12.35)mmHg,组间差异均有统计学意义(t=8.749、9.438,均P<0.05).观察组氯胺酮使用总量为(42.33±5.85)mg,苏醒时间为(5.56±2.03)min,疼痛评分为(2.16±1.05)分,Watcha评分为(1.65±0.59)分,PAED评分为(5.23±1.04)分;对照组氯胺酮使用总量为(72.53±16.58)mg,苏醒时间为(13.29±4.66)min,疼痛评分为(4.29±2.35)分,Watcha评分为(2.84±1.46)分,PAED评分为(8.75±2.19)分,组间差异均有统计学意义(t=11.698、8.239、7.763、6.997、8.168,均P<0.05).观察组呼吸抑制、烦躁苦恼和恶心呕吐发生率分别为1.18%、3.53%和3.53%,对照组分别为9.41%、15.29%和16.47%,组间差异均有统计学意义(χ2=4.174、3.589、4.281,均P<0.05).结论应用咪达唑仑在小儿包皮环切术中对患儿生命体征影响小,减轻术后苏醒躁动,缩短了苏醒时间,减少麻醉并发症发生,值得在临床推广应用.

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abstracts:

Objective To explore the effect of midazolam on the agitation and wake time of the postoperative resuscitation in pediatric circumcision.Methods Clinical data of 170 cases of pediatric circumcision were retrospectively analyzed.They were divided into control group and observation group according to the anesthesia scheme ,85 cases in each group.The control group was anesthetized with sevoflurane compound ketamine ,and the observation group was given trifluorothane and ketamine combined with midazolam .The effects of the two groups were compared .Results The cardiac rhythm and the central arterial pressure at first 10min of operation in the observation group were (99.64 ±5.97) times/min,(65.81 ±5.63) mmHg,respectively,which in the control group were (122.38 ± 12.54)times/min,(86.49 ±12.35) mmHg,respectively,the differences between the two groups were statistically significant(t=8.749,9.438,all P<0.05).The total amount of ketamine,waking time,pain score,Watcha score, PAED score in the observation group were (42.33 ±5.85)mg,(5.56 ±2.03)min,(2.16 ±1.05)points,(1.65 ± 0.59)points,(5.23 ±1.04) points,respectively,which in the control group were (72.53 ±16.58) mg,(13.29 ± 4.66)min,(4.29 ±2.35) points,(2.84 ±1.46)points,(8.75 ±2.19)points,respectively,the differences between the two groups were statistically significant(t=11.698,8.239,7.763,6.997,8.168,all P<0.05).The incidence rates of respiratory inhibition ,fidgety,nausea and vomiting of the observation group were 1.18%,3.53%,3.53%, respectively,which of the control group were 9.41%,15.29%,16.47%,respectively,the differences between the two groups were statistically significant(χ2 =4.174,3.589,4.281,all P<0.05).Conclusion Application of midazolam in pediatric prepuce intraoperatively has little influence on the vital signs of children ,and can relieve postoperative awaken agitation , reduce the time of awakening and anesthesia complications , and it is worthy of popularizing in clinical application .

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作者: 陈小珍 [1] 林小雷 [1]
期刊: 《中国基层医药》2018年25卷8期 961-964页 ISTIC
栏目名称: 论著
DOI: 10.3760/cma.j.issn.1008-6706.2018.08.003
发布时间: 2018-04-27
基金项目:
Public Welfare Science and Technology Planning Projects of Wenzhou City ,Zhejiang Province (Y20160385)浙江省温州市公益性科技计划项目
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