咪达唑仑口服溶液在患儿七氟烷麻醉术后躁动的临床应用

Clinical Application of Midazolam Oral Solution in Young Children with Agitation after Sevoflurane Anesthesia

摘要: 目的：探讨咪达唑仑口服液对七氟烷麻醉儿童术后躁动、不良反应的影响。方法：选择2022年3月至2023年6月日照市中心医院收治的腹部手术患儿120例，采用随机数字表法将患者分为3组，A组：术前30 min口服咪达唑仑口服溶液0.5 mg/kg，麻醉后经鼻给予盐水滴鼻处理；B组：术前30 min口服普通糖浆，麻醉后经鼻给予右美托咪定1 μg/kg滴鼻处理；C组：术前30 min口服普通糖浆，麻醉后经鼻给予盐水滴鼻处理。收集患儿一般资料，包括性别、年龄、ASA分级。记录麻醉诱导即刻(T1)、拔管前(T2)、拔管即刻(T3)患儿平均血压(MAP)、心率(HR)变化。记录患儿的手术时间、复苏时间。记录患儿的躁动发生率、以及术后不良反应(恶心、呕吐)的发生情况。结果：三组患儿一般情况，包括性别、年龄、ASA分级、手术时间差异无统计学意义(P > 0.05)。与C组患儿复苏时间比较，A组、B组患儿复苏时间均降低(P < 0.05)；与B组患儿复苏时间比较，A组患儿复苏时间均降低(P < 0.05)。三组患儿在T1、T2时MAP、HR差异无统计学意义(P > 0.05)。在T3时间点，与C组患儿MAP、HR比较，A组、B组患者MAP、HR均降低(P < 0.05)；A组与B组患儿MAP、HR差异无统计学意义(P > 0.05)。与C组患儿比较，A组和B组患儿术后不良反应(恶心、呕吐)降低(P < 0.05)。与C组患儿比较，A组和B组患儿术后躁动发生率降低(P < 0.05)；与B组患儿术后躁动发生率比较，A组患儿术后躁动发生率降低(P < 0.05)。结论：咪达唑仑口服溶液可改善七氟烷麻醉儿童术后躁动、不良反应，安全性高。

Abstract: Objective: To investigate the effect of midazolam oral liquid on postoperative agitation and adverse reactions in children undergoing sevoflurane anesthesia. Methods: A total of 120 children with ab-dominal surgery admitted to Rizhao Central Hospital from March 2022 to June 2023 were selected. The patients were divided into three groups by random number table method. Group A: oral mid-azolam oral solution 0.5 mg/kg 30 minutes before operation, and nasal saline nasal drip after an-esthesia. Group B: oral administration of ordinary syrup 30 min before operation, nasal administra-tion of dexmedetomidine 1 μg/kg nasal drip after anesthesia; Group C: oral administration of ordi-nary syrup 30 min before operation, and nasal administration of saline nasal drip after anesthesia. The general data of the children were collected, including gender, age and ASA classification. The changes of mean blood pressure (MAP) and heart rate (HR) were recorded immediately after anes-thesia induction (T1), before extubation (T2) and immediately after extubation (T3). The anesthesia time and recovery time of the children were recorded. The incidence of agitation and postoperative adverse reactions (nausea and vomiting) were recorded. Results: There was no significant differ-ence in the general conditions of the three groups of children, including gender, age, ASA grade, and surgery time (P > 0.05). Compared with the recovery time of group C, the recovery time of group A and group B decreased (P < 0.05). Compared with the recovery time of group B, the recovery time of group A decreased (P < 0.05). There was no significant difference in MAP and HR between the three groups at T1 and T2 (P > 0.05). At T3 time point, compared with MAP and HR in group C, MAP and HR in group A and group B decreased (P < 0.05). Compared with group C, the postoperative adverse reactions (nausea and vomiting) in group A and group B were decreased (P < 0.05). Compared with group C, the incidence of postoperative agitation in group A and group B was lower (P < 0.05). Com-pared with the incidence of postoperative agitation in group B, the incidence of postoperative agita-tion in group A decreased (P < 0.05). Conclusion: Midazolam oral solution can improve postopera-tive agitation and adverse reactions in children with sevoflurane anesthesia, with high safety.