瑞芬太尼对学龄前儿童斜视术后呕吐的影响：一项前瞻性随机对照试验

瑞芬太尼对学龄前儿童斜视术后呕吐的影响：

一项前瞻性随机对照试验

贵州医科大学     麻醉与心脏电生理课题组

翻译：安丽  编辑：张中伟  审核：曹莹

罂 粟 摘 要  

背景：在斜视手术中阿片类药物的使用是术后呕吐的危险因素。我们对瑞芬太尼是否与术后呕吐发生率存在剂量依赖性进行了评估。

方法：我们对拟接受斜视手术的60例患儿纳入本项研究。患儿被随机分为三组;H组(高剂量瑞芬太尼组)、L组(低剂量瑞芬太尼组)、C组(对照组)，每组各20例。气管插管后，H组和L组患儿在2min内分别静脉泵注瑞芬太尼1.0 μ g/kg和0.5 μ g/kg，随后H组、L组患儿术中连续泵注瑞芬太尼0.1µg/kg/min。C组患者未使用任何剂量的瑞芬太尼。术后给予芬太尼静脉注射(1µg/kg)控制疼痛。

结果：主要结果是术后24小时内呕吐发生率的差异。三组患者术后呕吐发生率比较差异无统计学意义。三组间突发性躁动及术后疼痛程度无显著性差异。

结论：在儿童斜视手术中，瑞芬太尼对术后呕吐无剂量依赖性。

原始文献来源：Hyun-Seong Lee , Ki Hwa Lee , Byeongcheol Lee , Daeseok Oh, Sung Hyun Shin and Yei Heum Park.Effect of Remifentanil on Postoperative Vomiting After StrabismusSurgery in Preschool Children: A Prospective Randomized Controlled Trial.Anesth Pain Med. 2022 February; 12(1):e122160.

英文原文   

Effect of Remifentanil on Postoperative Vomiting After StrabismusSurgery in Preschool Children: A Prospective Randomized Controlled Trial

Abstract

Background: Strabismus surgery and the use of opioid are risk factors of postoperative vomiting. We evaluated whether there is a dose-dependent effect of remifentanil on the incidence of postoperative vomiting.

Methods: Sixty pediatric patients who were scheduled for strabismus surgery were enrolled. Patients were randomly divided into three groups; Group H (high-dose remifentanil group), Group L (low-dose remifentanil group), and Group C (control group). After endotracheal intubation, patients in the Group H and L received an intravenous bolus dose of remifentanil of 1.0µg/kg and 0.5µg/kg over 2 min, respectively. Group H and L patients received a continuous infusion of remifentanil (0.1 µg/kg/min) during the surgery.The patients in Group C did not have any dose of remifentanil. Intravenous fentanyl (1 µg/kg) was administered to the patients for postoperative pain control.

Results: The primary outcome was a difference of the incidence of postoperative vomiting within 24 hours after surgery. There was no significant difference in incidence of postoperative vomiting between three groups. The degree of emergence agitation and postoperative pain did not show any significant difference between three groups.

Conclusions: The intraoperative administration of remifentanil did not show dose-dependent effect on postoperative vomiting in pediatric strabismus surgery.

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