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目的观察小剂量芬太尼对七氟醚麻醉下小儿眼科手术苏醒期躁动的影响。方法选择2015年6月至2016年12月择期行白内障摘除术患儿60例,年龄3~7岁,随机分为两组:生理盐水组(C组)和芬太尼组(F组),每组30例。F组患儿麻醉诱导给予芬太尼1μg/kg,C组患儿给予等容积的生理盐水。观察两组患儿苏醒期躁动发生率;并记录患儿苏醒时间和麻醉后恢复室(PACU)停留时间;观察围术期患儿不良反应发生情况;监测入室(T0)、手术开始(T1)、手术结束(T2)、苏醒时(T3)和离室时(T4)的心率(HR)、血氧饱和度(Sp O2)的变化。结果F组患儿苏醒期躁动发生率明显低于C组(33.3%vs 86.7%,P<0.05);术后苏醒时间和PACU停留时间明显长于C组(P均<0.05);两组围术期不良反应发生率比较差异无统计学意义(P均>0.05)。两组各时间点HR、Sp O2比较差异无统计学意义(P均>0.05)。结论小剂量芬太尼可显著减轻七氟醚麻醉下小儿眼科手术后苏醒期躁动发生,延长苏醒和PACU停留时间。
Objective To observe the effect of small dose of fentanyl on wakefulness in pediatric ophthalmic surgery under anesthesia with sevoflurane. Methods Sixty children (aged 3-7 years) undergoing elective cataract extraction from June 2015 to December 2016 were randomly divided into two groups: saline group (group C) and fentanyl group (group F) 30 cases in each group. F group anesthesia induced fentanyl 1μg / kg, C group given equal volume of saline. The incidence of agitation during the recovery period was observed in both groups. The recovery time and the residence time of PACU in children were recorded. The incidence of adverse reactions in children during perioperative period was observed. T0, T1, , Heart rate (HR), blood oxygen saturation (Sp O2) at the end of surgery (T2), awake time (T3) Results The incidence of restlessness in group F was significantly lower than that in group C (33.3% vs 86.7%, P <0.05). The recovery time and PACU stay time in group F were significantly longer than those in group C (all P <0.05) The incidence of adverse reactions was no significant difference (P> 0.05). There was no significant difference in HR and Sp O2 between two groups at any time point (P> 0.05). Conclusions Small dose of fentanyl can significantly reduce the irritability of wakefulness after pediatric ophthalmic surgery under anesthesia with sevoflurane, prolong the recovery and PACU residence time.