摘要
目的采用随机对照试验(RCT)研究艾司氯胺酮在儿童全麻诱导中的效果。方法选取2022年10月-2023年10月期间在乌鲁木齐市口腔医院儿童牙科及颌面外科就诊,需要在全身麻醉下行口腔治疗及手术的儿童251例,采用随机双盲研究方法,按随机数表法分为对照组(126例,静脉予以阿芬太尼)和试验组(125例,静脉予以艾司氯胺酮)。比较2组血流动力学、肺功能、肺血流和全麻效果。结果与对照组比较,试验组T2、T3、T4的心率(HR)和平均动脉压(MAP)更高(P<0.05);相较于T1,试验组T2、T4的HR和MAP均升高,T3的MAP降低(P<0.05),对照组T2、T3、T4的HR和MAP均降低,T4的氧饱和度(SpO2)降低(P<0.05)。与对照组比较,试验组T3、T4的呼吸频率(R)和分钟通气量(MV)更高,潮气量(TV)更低(P<0.05);相较于T1,试验组T3、T4的R升高(P<0.05),对照组T3、T4的R降低(P<0.05),2组T3、T4的TV、MV均降低(P<0.05)。与对照组比较,试验组T3、T4的呼气末二氧化碳浓度(ETCO_(2))均更低(P<0.05);与对照组比较,试验组全麻效果Ⅰ级率更低,Ⅱ级率更高(P<0.05)。结论相较于阿芬太尼应用于儿童全麻诱导中,艾司氯胺酮可更有效稳定血流动力学,改善肺通气功能和肺血流,但其麻醉效果略低于阿芬太尼。
Objective To investigate the effect of esketamine in the induction of general anesthesia in children using randomized controlled trial(RCT).Methods 251 children who visited Department of Children's Dental and Maxillofacial Surgery of Urumqi Stomatological Hospital from October 2022 to October 2023 were selected.These children required oral treatment and surgery under general anesthesia.Pediatric patients were divided into the control group(126 cases)and the experiment group(125 cases)according to random number table method using a randomized double-blind study method,.The control group received intravenous administration of fentanyl,while the experiment group received intravenous administration of esketamine.Hemodynamics,lung function,pulmonary blood flow and general anesthesia effect were compared between two groups.Results Compared with the control group,heart rate(HR)and mean arterial pressure(MAP)of T2,T3,and T4 in the experiment group were higher(P<0.05);Compared with T1,HR and MAP of T2 and T4 in the experiment group increased,while MAP of T3 decreased(P<0.05).HR and MAP of T2,T3,and T4 in the control group decreased,and oxygen saturation(SpO_(2))of T4 decreased(P<0.05).Compared with the control group,respiratory rate(R)and minute ventilation volume(MV)of T3 and T4 in the experiment group were higher,and tidal volume(TV)was lower(P<0.05);Compared with T1,the R of T3 and T4 in the experiment group increased(P<0.05),while the R of T3 and T4 in the control group decreased(P<0.05).The TV and MV of T3 and T4 in both groups decreased(P<0.05).Compared with the control group,the end-tidal carbon dioxide(ETCO2)levels of T3 and T4 in the experiment group were lower(P<0.05).Compared with the control group,in the experiment group,the general anesthesia effect was lower in grade I rate and higher in grade II rate(P<0.05).Conclusion Compared with fentanyl used for general anesthesia induction in children,esketamine can more effectively stabilize hemodynamics,improve lung ventilation function and pulmonary blood flow,but its anesthetic effect is slightly lower than that of fentanyl.
作者
朱歆洁
张敏
秦曦
高娟
马丽娜
ZHU Xinjie;ZHANG Min;QIN Xi;GAO Juan;MA Lina(Urumqi Stomatological Hospital,Urumqi 832000,China)
出处
《长春中医药大学学报》
2025年第1期89-93,共5页
Journal of Changchun University of Chinese Medicine
基金
乌鲁木齐市卫生健康委科技计划项目(202227)。
关键词
儿童
全麻诱导
艾司氯胺酮
随机对照试验
children
induction of general anesthesia
esketamine
randomized controlled trial
作者简介
朱歆洁(1982-),女,副主任医师,主要从事临床麻醉、口腔麻醉方面研究;通信作者:马丽娜,女,主治医师,电子信箱-184346975@qq.com。
