文章摘要

盐酸艾司氯胺酮预处理对小儿全麻斜视术后恢复的影响

作者: 1李春伟, 2丁莉, 1李北平, 1闫龙剑, 1马兴对
1 徐州市第一人民医院(徐州医科大学附属徐州市立医院)麻醉科，江苏 徐州 221116
2 徐州市矿务局集团总医院麻醉科，江苏 徐州 221000
通讯: 马兴对 Email: 787609051@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.08.028
基金: 徐州医科大学附属医院发展基金(优秀人才基金)(XYFY2020003)。

摘要

目的：探讨盐酸艾司氯胺酮预处理对小儿全麻斜视术后恢复的影响。方法：选择拟在全麻下行斜视矫正术的患儿96例，盲选法随机分为艾司氯胺酮组(S组)与生理盐水组(D组)，每组48例，麻醉诱导后给予相应型号的喉罩置入，诱导后S组给予盐酸艾司氯胺酮0.5 mg/kg(0.02 mL/kg)，D组给予等容量的生理盐水。比较2组患儿苏醒期躁动发生率、术后疼痛评分及恶心呕吐等不良反应发生情况。结果：D组苏醒期躁动发生率为25%，S组苏醒期躁动发生率为8.3%，2组差异有统计学意义(P<0.05)。S组苏醒后5、10、30 min疼痛评分均低于D组(均P<0.05)；2组手术时间、拔管时间、麻醉后监测治疗室(post-anesthesia care unit，PACU)停留时间的差异均无统计学意义(均P>0.05)；在用药20和30 min时，S组与D组的患儿心率、呼吸频率均有所下降(均P<0.05)，2组血氧饱和度比较，差异无统计学意义(P>0.05)。2组患儿苏醒期恶心、呕吐、皮肤瘙痒、寒战及呼吸抑制的发生率差异均无统计学意义(均P>0.05)。结论：使用盐酸艾司氯胺酮预处理可以减少患儿全麻斜视手术后的疼痛程度，降低术后躁动的发生，且不增加不良反应的发生，值得进一步推广。
关键词： 盐酸艾司氯胺酮；斜视；苏醒期躁动；术后疼痛

Effect of pretreatment with esmketamine hydrochloride on postoperative recovery of strabismus in children under general anesthesia

Authors: 1LI Chunwei, 2DING Li, 1LI Beiping, 1YAN Longjian, 1MA Xingdui
1 Department of Anesthesiology, Xuzhou First People’s Hospital (Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University), Xuzhou Jiangsu 221116, China
2 Department of Anesthesiology, Xuzhou Mining Bureau Group Hospital, Xuzhou Jiangsu 221000, China

CorrespondingAuthor: MA Xingdui Email: 787609051@qq.com

DOI: 10.3978/j.issn.2095-6959.2022.08.028

Foundation: This work was supported by the Development Fund of Affiliated Hospital of Xuzhou Medical University (Fund for Excellent Talents), China (XYFY2020003).

Abstract

Objective: To investigate the effect of esmketamine hydrochloride pretreatment on postoperative recover of strabismus surgery in children. Methods: Ninety-six children who planned to receive strabismus correction under general anesthesia were selected and randomly divided into an experimental group and a control group by blind selection, each group with 48 cases. After anesthesia induction, the corresponding type of laryngeal mask was inserted. After the induction, the experimental group was given esmketamine hydrochloride 0.5 mg/kg (0.02 mL/kg), and the control group was given an equal volume of sodium chloride injection. The incidence of agitation, postoperative pain score, nausea, vomiting and other adverse reactions were recorded and compared between the 2 groups. Results: The incidence of emergence agitation was 25% (12/48) in the control group and 8.3% (4/48) in the experimental group, and the difference was statistically significant (P<0.05). Compared with the control group, the pain scores of the experimental group were lower at 5, 10 and 30 min after waking up, and the difference was statistically significant (all P<0.05). Compared with the control group, there was no significant difference in operation time, extubation time, and post-anesthesia care unit (PACU) residence time of the experimental group (all P>0.05). Compared with the control group, the heart rate and respiratory rate of the children in the experimental group were lower than those in the control group at 20 and 30 min, and the difference was statistically significant (all P<0.05). There was no significant difference in blood oxygen saturation between the 2 groups (P>0.05). There was no statistically significant difference in the incidence of adverse reactions such as nausea, vomiting, skin pruritus, chills, and respiratory depression between the 2 groups of patients during the recovery period (all P>0.05). Conclusion: Esmketamine hydrochloride pretreatment can reduce the pain degree and postoperative agitation in children with strabismus surgery, and does not increase the incidence of adverse reactions, which is worthy of further promotion.

Keywords： esmketamine hydrochloride; strabismus; emergence agitation; postoperative pain

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