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目的:比较3种麻醉诱导方法对咽喉部手术患儿血流动力学和麻醉苏醒及质量的影响。方法:ASAⅠ～Ⅱ级、年龄3～14岁,择期行腺样体切除和/或扁桃体切除术患儿48例,随机分为氯胺酮组(K组)、舒芬太尼0.2μg/kg组(S1组)和舒芬太尼0.3μg/kg组(S2组),每组各16例。记录手术结束至拔气管导管时间、复苏时间、复苏期躁动发生情况及不同时间节点[基础值(T0),诱导后(T1),插管后即刻(T2),手术开始(T3),手术结束(T4)]的平均动脉压、心率。结果:K组T1,T2,T3,T4心率较T0显著性增快(P<0.05),T2,T3平均动脉压较T0显著性升高(P<0.05);S1组T1,T2,T3,T4心率较T0增快(P<0.05),平均动脉压比较差异无统计学意义(P>0.05);S2组T2,T3,T4心率较T0增快(P<0.05),T1平均动脉压较T0降低(P<0.05),而T2,T3,T4与T0比较差异无统计学意义(P>0.05);S1组和S2组拔气管导管时间、麻醉复苏时间较K组缩短(P<0.05),S1组拔气管导管时间短于S2组(P<0.05);3组复苏期躁动发生率差比较异无统计学意义(P>0.05),亦无呼吸抑制、低氧血症等并发症的发生。结论:舒芬太尼用于儿童咽喉部手术血流动力学稳定、拔气管导管时间和复苏时间缩短。
Objective: To compare the effects of three anesthesia induction methods on hemodynamics and anesthesia recovery and quality in children with throat surgery. Methods: Forty-eight ASA Ⅰ ~ Ⅱ patients, aged from 3 to 14 years, undergoing elective adenoidectomy and / or tonsillectomy were randomly divided into ketamine group (K group), sufentanil group (0.2μg / kg group S1 group) and sufentanil 0.3μg / kg group (S2 group), each group of 16 cases. The time from the end of operation to the endotracheal tube, the time of recovery, the restlessness of the resuscitation period and the time of onset [T0, T1, T2, T3, and end of surgery were recorded (T4)] mean arterial pressure, heart rate. Results: Compared with T0, the heart rate of T1, T2, T3 and T4 in group K was significantly higher than that in group T (P <0.05) T4 heart rate was higher than T0 (P <0.05), mean arterial pressure was no significant difference (P> 0.05); S2 group T2, T3, T4 heart rate was higher than T0 (P0.05), T1 mean arterial pressure T0 decreased (P <0.05), while T2, T3, T4 had no significant difference with T0 (P> 0.05). The time of tracheal intubation and anesthesia recovery in S1 and S2 group were shorter than those in K group (P <0.05) , And the time of tracheal intubation in group S1 was shorter than that in group S2 (P <0.05). There was no significant difference in the incidence of agitation in group 3 (P> 0.05), and no complication of respiratory depression and hypoxemia occur. Conclusions: Sufentanil is used to stabilize the hemodynamics of pediatric throat surgery, and the time of tracheal intubation and the time of recovery are shortened.