舒芬太尼、曲马多用于小儿鼾症手术苏醒期躁动的临床研究

目的：探究舒芬太尼与曲马多对用于小儿鼾症手术苏醒期躁动的作用与影响。方法：60例ASAI或II级扁桃体肥大或腺样体肥大的鼾症手术患儿，年龄6-14岁，无呼吸系统，循环系统等疾病，一般状态良好。随机分为舒芬太尼组（s组）和曲马多（T组），每组各30例。常规监测各项生命体征。于手术结束前20分钟（min），S组缓慢静脉输入0．15μg／kg舒芬太尼，T组静脉输入1．2mg／kg曲马多。观察各组的：平均动脉压 （MAP）、心率（HR）、血氧饱和度（SpO2），进行各组的镇静评分（RSS）、躁动评分（RS）、镇痛评分（VRS）、意识状态评分（OAAS）。记录拔管前（T0）、拔管时（T1）、拔管后5min（T2）、拔管后10min（T3）、拔管后20min（T4）各时间点各参数的变化。记录各组的恶心呕吐、呼吸抑制、烦躁等的发生率。结果：SpO2各组间无显著差异。MAP，HR在各时间点的变化T组大于S组，P〈0．05，有显著差异。T组在RS，RSS，VRS评分与S组有显著差异，P〈0．05。结论：0．15μg／kg的舒芬太尼在小儿鼾症手术的苏醒期可以维持稳定的血流动力学，副作用小，镇痛效果良好，可以有效减少小儿苏醒期的躁动。

Sufentanil,Tramadol Clinical Study of Surgery for Snoring in Children Restlessness

Objective： Research sufentanil, tramadol for children with snoring surgery waking restlessness comparison. Methods： 60 cases ofASA I or II snoring surgery in children with large tonsils or adenoid hypertrophy, age 6-14 years old, no respiratory system, circulatory system diseases such as generally in good condition. Sufentanil group （S） and tramadol （T group） were randomly divided into 30 cases in each. Routine monitoring of vital signs. Surgery before the end of 20 minutes （min）, S slow intravenous input 0.15 Ixg / kg sufentanil, T group intravenous infusion of 1-2 mg / kg tramadol. Observed in each group： mean arterial pressure （MAP）, heart rate （HR）, oxygen saturation （SpO2）, sedation score （RSS） in each group, restlessness score （RS）, analgesic score （VRS）, the state of consciousnessscore （OAAS）. Recorded before extubation （To）, extubation （T1）, after extubation extubation after 5min （T2）, 10min （T3）, 20 min （T4） at all time points after extubation parameter changes. Record the incidence of each group of nausea and vomiting, respiratory depression, irritability. Results： SpO2 between the groups was no significant difference. MAP, HR changes in T group at all time points greater than the S group （P 〈0.05）, there are significant differences. T group in the RS, RSS, VRS score S group showed significant differences （P 〈0.05）. Conclusion： 0.15 μg / kg of sufentanil in children with snoring surgery recovery period can maintain a stable blood flow dynamics, side effects, good analgesic effect, can effectively reduce pediatric emergence agitation.