| 摘要: |
| 目的:探讨不同剂量舒芬太尼复合丙泊酚对小儿腹腔镜手术麻醉苏醒期躁动( EA)、认知功能及呼吸循环的影响。
方法:选取2022 年9 月至2024 年9 月石家庄市妇幼保健院行腹腔镜手术的165 例患儿,按随机数表法分为A 组(输注舒芬太
尼0. 3 μg/ kg)、B 组(输注舒芬太尼0. 4 μg/ kg)、C 组(输注舒芬太尼0. 5 μg/ kg),每组55 例。比较3 组患儿一般资料、不同时
间点EA 评分、认知功能评分和呼吸循环指标等。建立患儿相关指标在不同剂量舒芬太尼下的广义估计方程(GEE) 模型。采
用序贯法测定丙泊酚半数最大效应浓度(EC50),并分析患儿术后不良事件发生情况。结果:3 组患儿不同时间点EA 评分、简
易精神状态评价量表评分、心率、动脉血氧饱和度、呼气末二氧化碳分压、气道压力水平比较差异有统计学意义(P<0. 05)。序
贯法测定结果显示,A 组丙泊酚EC50 为6. 134 mg/ kg(95%CI 5. 372~6. 928),B 组丙泊酚EC50 为5. 405 mg/ kg(95%CI 4. 836~
6. 112),C 组丙泊酚EC50 为5. 376 mg/ kg( 95%CI 4. 754 ~ 6. 027)。3 组患儿不良事件发生率比较差异无统计学意义( χ2 =
4. 210,P =0. 123),但B 组不良事件的总风险率最低。结论:0. 4 μg/ kg 舒芬太尼复合丙泊酚应用于小儿腹腔镜手术可明显减少
患儿EA,改善患儿呼吸循环指标、减少术后认知功能损伤,并明显降低丙泊酚EC50,安全有效,值得临床推广应用。 |
| 关键词: 舒芬太尼 丙泊酚 小儿腹腔镜手术 苏醒期躁动 认知功能 呼吸循环 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.11.008 |
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| 基金项目: |
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| Clinical Study on Anesthesia and Recovery of Children Under Different Doses of Sufentanil Combined withPropofol for Laparoscopic Surgery |
| Cai Yajiao, Zhang Xiaonan, Li Xiaoli |
| (Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, China) |
| Abstract: |
| Objective: To explore the effects of different doses of sufentanil combined with propofol on emergence agitation (EA),
cognitive function and respiratory circulation during anesthesia recovery in children with laparoscopic surgery. Methods: From Sept.
2022 to Sept. 2024, totally 165 children who underwent laparoscopic surgery at Shijiazhuang Maternal and Child Health Hospital were
randomly divided into group A (with sufentanil infusion at 0. 3 μg/ kg), group B (with sufentanil infusion at 0. 4 μg/ kg), and group C
(with sufentanil infusion at 0. 5 μg/ kg) via the random number table method, with 55 cases in each group. General data, EA scores at
different time points, cognitive function scores, and respiratory circulation indicators of three groups were compared. Generalized
estimating equation (GEE) model of the children’s related indicators under different doses of sufentanil were established. The half
maximal effective concentration (EC50) of propofol was determined by the sequential method, and the occurrence of postoperative
adverse events was analyzed. Results: There were statistically significant differences in EA scores, Mini-Mental State Examination
scores, heart rate, arterial oxygen saturation, end-tidal carbon dioxide partial pressure, and airway pressure levels among three groups at
different time points (P<0. 05). The sequential method measurement results showed that, the EC50 of propofol was 6. 134 mg/ kg (95%
CI 5. 372 to 6. 928) in group A, 5. 405 mg/ kg (95%CI 4. 836 to 6. 112) in group B, and 5. 376 mg/ kg (95%CI 4. 754 to 6. 027) in
group C, respectively. There was no statistically significant difference in the incidence of adverse events among three groups (χ2 =
4. 210, P =0. 123), but the total risk rate of adverse events in group B was the lowest. Conclusion: Sufentanil infusion at 0. 4 μg/ kg
combined with propofol can significantly reduce EA in children with laparoscopic surgery, improve the respiratory circulation indicators,
reduce postoperative cognitive dysfunction, and significantly lower the EC50 of propofol. It is safe, effective and worthy of clinical
promotion and application. |
| Key words: sufentanil propofol laparoscopic surgery in children agitation during anesthesia recovery cognitive function respiratory
circulation |
