| 摘要: |
| 目的:观察艾司氯胺酮、舒芬太尼联合镇痛在小儿扁桃体、腺样体切除术中应用的安全性及有效性。 方法:选取 2022 年 11 月至 2024 年 12 月在我院行扁桃体、腺样体切除术的 104 例儿童患者,分为观察组和对照组各 52 例。 观察组诱导应用艾司 氯胺酮 0. 5 mg / kg,舒芬太尼 0. 3 μg / kg,丙泊酚 1 mg / kg;对照组诱导应用舒芬太尼 0. 5 μg / kg,丙泊酚 2 mg / kg。 记录患儿入室 时(T0)、诱导气管插管后(T1)、手术开始时(T2)、拔除气管导管时(T3)平均动脉压和心率,记录拔管后 5 min( T4)、拔管后 15 min(T5)的躁动评分和疼痛评分,记录拔管时间、麻醉后监护室( PACU) 停留时间及呼吸抑制、恶心、呕吐等不良反应。 结果:两组患儿性别、年龄、手术时间比较差异无统计学意义(P>0. 05)。 观察组自主呼吸恢复时间、拔管时间及 PACU 停留时 间明显短于对照组(P<0. 05),麻醉诱导期血流动力学波动及苏醒期躁动、呼吸抑制发生率低于对照组(P<0. 05)。 结论:艾司 氯胺酮、舒芬太尼联合镇痛应用于小儿扁桃体、腺样体切除术能使患儿围术期血流动力学更平稳,镇痛效果确切且不良反应发 生率更低。 |
| 关键词: 艾司氯胺酮 舒芬太尼 联合镇痛 扁桃体切除术 腺样体切除术 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2025.09.004 |
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| 基金项目:河北省卫生健康委科研项目,编号 20241636。 |
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| Application of Esketamine Combined with Sufentanil Analgesia in Children with Tonsillectomy and Adenoidectomy |
| He Huizhen, Wang Xueran, Gao Ning, Wang Zhicun, Guan Xiaomeng, Wang Mengdi, Yan Yaping |
| (The Second Central Hospital of Baoding, Hebei Zhuozhou 072750, China) |
| Abstract: |
| Objective: To observe the safety and efficacy of esketamine combined with sufentanil analgesia in children with tonsillectomy and adenoidectomy. Methods: A total of 104 children undergoing tonsillectomy and adenoidectomy in our hospital from Nov. 2022 to Dec. 2024 were extracted to be divided into the observation group and control group, with 52 cases in each group. The observation group was induced with 0. 5 mg / kg of esketamine, 0. 3 μg / kg of sufentanil, and 1 mg / kg of propofol. The control group was induced with 0. 5 μg / kg of sufentanil and 2 mg / kg of propofol. Mean arterial pressure and heart rate were recorded at baseline ( T0), post-intubation (T1), surgery start (T2), and extubation (T3). Agitation and pain scores at 5 min after extubation (T4) and 15 min after extubation (T5) were collected. Extubation time, Post-Anesthesia Care Unit ( PACU) stay duration, adverse drug reactions such as respiratory depression, nausea, and vomiting were documented. Results: No significant differences were observed in gender, age, and surgery duration between two groups (P > 0. 05). The recovery time of spontaneous breathing, extubation time, and PACU stay duration in observation group were significantly shorter than those in control group (P < 0. 05). Changes in hemodynamics during the induction period of anesthesia and incidence of agitation and respiratory depression were significantly lower in observation group than those in control group (P<0. 05). Conclusion: Esketamine combined with sufentanil analgesia provide more stable perioperative hemodynamics, effective pain control, and fewer adverse drug reactions in children with tonsillectomy and adenoidectomy. |
| Key words: esketamine sufentanil combined analgesia tonsillectomy adenoidectomy |
