【摘要】 目的探讨新斯的明联合氟马西尼在儿童鼾症全身麻醉复苏中的应用效果。方法将60例拟行全身麻醉下低温等离子射频消融术的儿童鼾症患者分为联合组及对照组各30例,联合组在患儿自主呼吸恢复后使用新斯的明联合阿托品和氟马西尼,对照组自然苏醒,2组均在生命体征稳定后拔除气管导管,比较2组清醒时间、拔管时间,比较联合组给药后不同时间点的生命体征及不良反应等指标。结果联合组清醒时间为(8±3) min、拔管时间为(13±3) min,对照组清醒时间为(20±5) min、拔管时间为(26±2) min,2组比较差异均有统计学意义(P均<0.05)。联合组复苏时给予新斯的明联合阿托品和氟马西尼后,其平均动脉压于给药后1、5 min呈增长趋势(P均<0. 017),给药后10 min开始下降;脉氧饱和度给药后1 min与给药前无明显差异(P>0.017),于给药后5、10 min呈增长趋势(P均<0. 017);心率于给药后1、5 min呈增长趋势(P均<0. 017),给药10 min后开始下降。联合组无恶心、呕吐、支气管痉挛、低氧血症等不良反应。结论新斯的明联合氟马西尼应用于儿童鼾症的全身麻醉复苏,可以减少清醒时间及拔管时间,且无明显不良反应。更多还原

【Abstract】 Objective To evaluate the clinical efficacy of the application of neostigmine combined with flumazenil in the recovery from general anesthesia in snoring children. Methods Sixty children with snoring scheduled to undergo radiofrequency coblation under general anesthesia were divided into the combined(n=30) and control groups(n=30). In the combined group, the children were administered with neostigmine combined with atropine and flumazenil after the recovery of spontaneous respiration and those in the control group obtained spontaneous recovery without medication. The tracheal catheter was extubated after the vital signs were stable in both groups. The awakening time and extubation time were statistically compared between two groups. The vital signs and adverse events at different time point after medicine administration were compared in the combined group. Results In the combined group,the awakening time was(8±3) min and the extubation time was(13±3) min,significantly shorter compared with(20±5) min and(26±2) min in the control group(both P<0.05). In the combined group, neostigmine combined,with atropine and flumazenil was administered after the recovery from general anesthesia. The mean arterial pressure tended to increase at 1-and 5-min after medicine administration(both P<0.017), whereas started to decline at 10-min after drug administration. The pulse oxygen saturation did not significantly differ before and at 1-min after medicine administration(P>0.017), whereas tended to significantly increase at 5-and 10-min after drug administration(both P<0.017). The heart rate was inclined to increase at 1-and 5-min(both P<0.017), whereas began to decline at 10 min. In the combined group, no nausea, vomitting, bronchospasm, hypoxemia and other complications were observed. Conclusion Neostigmine in combination with flumazenil is applicable to the recovery from general anesthesia in snoring children, which can shorten the awakening and extubation time and yield no evident adverse events.更多还原