| 党 璐,常宝生,高 洁,毕翻利,李 涛.右美托咪定与氯胺酮在短小手术麻醉后痛觉过敏及苏醒躁动影响[J].,2020,(11):2131-2134 |
| 右美托咪定与氯胺酮在短小手术麻醉后痛觉过敏及苏醒躁动影响 |
| Effects of Dexmedetomidine and Ketamine on Hyperalgesia and Wakefulness after Short Anesthesia |
| 投稿时间：2019-12-03 修订日期：2019-12-27 |
| DOI：10.13241/j.cnki.pmb.2020.11.028 |
| 中文关键词: 右美托咪定 氯胺酮 短小手术 麻醉 痛觉过敏 苏醒躁动 |
| 英文关键词: Dexmedetomidine Ketamine Short-term surgery Anesthesia Hyperalgesia Waking restlessness |
| 基金项目:国家自然科学基金项目（81273902） |
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| 中文摘要: |
| 摘要 目的：探究右美托咪定与氯胺酮对短小手术麻醉后痛觉过敏及苏醒躁动的影响。方法：将2017年2月至2019年2月我院手术治疗的93例骨折患儿设为研究对象，将其随机分为A、B、C三组（每组各31例患儿），A组患儿在手术麻醉前30 min静注0.5 μg/kg的右美托咪定，B组患儿静注0.5 mg/kg的氯胺酮，C组患儿注射与A、B两组相同剂量的生理盐水，分别使用Ramasy镇静程度量表评估三组患儿苏醒躁动情况，使用Ramasy镇静程度评分评估三组患儿术后镇静情况，使用视觉模拟量表（visual analog scale，VAS）记录三组患儿术后从麻醉药停止使用至VAS评分到达4的时间，而后记录三组患儿使用镇痛药VAS疼痛度降至4以下的实践，最后记录三组患儿术后2 h、4 h及6 h的疼痛度；结果：（1）C组患儿躁动出现率显著高于A组和B组（P<0.05），A组和B组对比无差异（P>0.05）；（2）A组Ramasy镇静程度评分高于B组，B组高于C组（P<0.05）；（3）A组VAS到达4的时间显著长于B组和C组，且B组也长于C组（P<0.05），使用镇痛药后A组VAS评分下降至4的时间显著短于B组和C组，且B组也短于C组（P<0.05）；（4）患儿术后2 h、4 h、6 h时VAS评分均显著降低，且A组显著低于B组和C组，B组显著低于C组（P<0.05）。结论：对实施短小手术患儿应用右美托咪定或氯胺酮能够显著降低患儿术后躁动出现率，同时缓解患儿应用麻醉药后出现的痛觉过敏现象，有助于提高术后安全性。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of dexmedetomidine and ketamine on hyperalgesia and restlessness after anesthesia in short-term operation. Methods: 93 children with fracture treated in our hospital from February 2017 to February 2019 were randomly divided into three groups: group A, group B and group C(31 children in each group). Group a received 0.5 μg/kg dexmedetomidine 30 min before anesthesia, group B received 0.5 mg/kg ketamine, group C received the same dose of normal saline as group A and group B, and ramasy was used for sedation The recovery and agitation of the three groups were assessed by the scale, the postoperative sedation of the three groups was assessed by the ramasy sedation degree score, the time from the time when the anesthetics were stopped to the time when the VAS score reached 4 was recorded by the visual analogue scale (VAS), and then the practice of reducing the VAS pain degree of the three groups to less than 4 was recorded. Finally, the time of 2 h, 4 h and 6 h after the operation was recorded by the three groups degree of pain. Results: (1) The incidence of agitation in children in group C was significantly higher than that in groups A and B (P<0.05), and there was no difference between groups A and B (P>0.05). (2) Ramasy sedation score in the group A was higher than the group B, and the group B was higher than the group C (P<0.05). (3) The time to reach VAS in the group A was significantly longer than that of the groups B and C, and the group B was longer than the group C(P<0.05), the time taken for the VAS score of the group A to decrease to 4 after using analgesics was significantly shorter than that of the groups B and C, and the group B was also shorter than that of the group C (P<0.05). (4) At 2 h, 4 h, and 6 h, the VAS scores were significantly reduced, and the A group was significantly lower than the group B and C, and the group B was significantly lower than the group C(P<0.05). Conclusion: The use of dexmedetomidine or ketamine in children undergoing short-term surgery can significantly reduce the incidence of postoperative restlessness and relieve the hyperalgesia after anesthesia, which is helpful to improve the postoperative safety. |
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