临床误诊误治2024，Vol.37Issue(6)：53-57,5.DOI:10.3969/j.issn.1002-3429.2024.06.011
艾司氯胺酮与右美托咪定辅助全麻对小儿腺样体扁桃体切除术PAED评分、苏醒质量和不良反应的影响
Effects of Esketamine and Dexmedetomidine Assisted General Anesthesia on PAED Score,Quality of Recovery and Adverse Reactions in Children Undergoing Adenotonsillectomy
摘要
Abstract
Objective To investigate the effects of Esketamine and Dexmedetomidine assisted general anesthesia on pediatric anesthesia emergence delirium scale(PAED)score,quality of recovery and adverse reactions in children undergoing adenoidectomy and tonsillectomy.Methods A total of 138 children undergoing adenoidectomy and tonsillectomy treated from October 2021 to October 2023 were selected and divided into group E(n=69)and group M(n=69)using simple random number table method.Both groups were given general anesthesia.Before induction of anesthesia,Esketamine was injected in-travenously in group E and Dexmedetomidine was injected intravenously in group M.The modified Aldrete score were recor-ded,and the mean arterial pressure(MAP)and heart rate(HR)were compared before induction(T0),after induction(T1),during intubation(T2),during adenoidectomy(T3)and at extubation(T4).The stress indexes[5-hydroxytryptamine(5-HT),norepinephrine(NE),epinephrine(E),cortisol(Cor)]were detected before and at 1 day after surgery.The maximum PAED score and the revised Face,Legs,Activity,Cry and Consolability scale(FLACC)score within 30 min after entering the recovery room following anesthesia were recorded,and the adverse reactions of anesthesia in the two groups were recorded.Results The modified Aldrete score of group E was higher than that of group M(P＜0.01).At T0-T4,MAP and HR in group E increased first and then decreased,while MAP and HR in group M decreased first and then increased.At T2 and T3,MAP and HR in group E were higher than those in group M(P＜0.05).The levels of 5-HT,NE,E and Cor in the two groups were higher than those before surgery,which,however,were lower in E group than in M group(P＜0.05).The scores of PAED and FLACC in group E were lower than those in group M(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Compared with Dexmedetomidine,Esketamine can reduce PAED score,improve recovery quality,reduce hemodynamic fluctuation and stress injury in children after adenoidectomy and tonsillectomy.关键词
腺样体扁桃体切除术/儿童/麻醉/艾司氯胺酮/右美托咪定/苏醒期躁动/苏醒质量/血流动力学Key words
Adenotonsillectomy/Child/Anesthesia/Esketamine/Dexmedetomidine/Emergence agitation/Recov-ery quality/Hemodynamics分类
医药卫生引用本文复制引用
李蕾,马伟,高岩,张瑜..艾司氯胺酮与右美托咪定辅助全麻对小儿腺样体扁桃体切除术PAED评分、苏醒质量和不良反应的影响[J].临床误诊误治,2024,37(6):53-57,5.基金项目
河北省医学科学研究重点课题计划项目(20240471) （20240471）
