首页|口服不同剂量咪达唑仑对腹腔镜腹股沟斜疝疝囊高位结扎术患儿术前焦虑的影响

口服不同剂量咪达唑仑对腹腔镜腹股沟斜疝疝囊高位结扎术患儿术前焦虑的影响

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目的 观察口服不同剂量咪达唑仑用于缓解腹腔镜腹股沟斜疝疝囊高位结扎术患儿术前焦虑的效果.方法 选择择期在全麻下行腹腔镜腹股沟斜疝疝囊高位结扎术的患儿 120 例,男93 例,女 27 例,年龄 2~6 岁,身高78~120 cm,体重 11~25 kg,ASA Ⅰ或Ⅱ级.采用随机数字表法将患儿分为三组:麻醉前 30 min 口服咪达唑仑 0.25 mg/kg 组(M1 组)、0.5 mg/kg(M2 组)和 0.75 mg/kg(M3 组),每组 40 例.记录服药前、与父母分离时、麻醉诱导即刻简化版改良耶鲁术前焦虑量表(mYPAS-SF)评分和麻醉诱导期合作度量表(ICC)评分.记录苏醒时间、拔管时间、PACU停留时间、术后 30 min 儿童麻醉苏醒期躁动量表(PAED)评分和改良面部表情疼痛量表(FLACC)评分.结果 与服药前比较,M2 组和M3 组在与父母分离时、麻醉诱导即刻mYPAS-SF评分明显降低(P<0.05).与M1 组比较,M2 组和M3 组与父母分离时、麻醉诱导即刻mYPAS-SF明显降低(P<0.05),麻醉诱导即刻ICC评分明显降低(P<0.05),苏醒时间、拔管时间和PACU停留时间明显延长(P<0.05),术后 30 min PAED评分明显降低(P<0.05).与M2 组比较,M3 组苏醒时间和拔管时间明显延长(P<0.05).结论 麻醉前30 min口服咪达唑仑0.5 mg/kg或0.75 mg/kg均可有效缓解患儿术前焦虑,提高麻醉诱导合作度,降低术后躁动的发生,口服咪达唑仑0.75 mg/kg的患儿苏醒时间和拔管时间延长,因此,口服咪达唑仑 0.5 mg/kg为患儿术前抗焦虑方案比较合适的剂量.
Effect of different oral dosage of midazolam on anxiety before laparoscopic high ligation of the hernia sac in children with oblique inguinal hernia
Objective To observe the efficacy of different dosage of midazolam oral solution in re-lieving anxiety in children undergoing laparoscopic high ligation of the hernia sac with oblique inguinal her-nia.Methods A total of 120 children,93 males and 27 females,aged 2-6 years,78-120 cm in height and 11-25 kg in weight,ASA physical statusⅠ orⅡ,were selected to perform laparoscopic high ligation of inguinal oblique hernia sac under general anesthesia.According to random number table method,the chil-dren were divided into three groups:the oral midazolam 0.25 mg/kg group(group M1),0.5 mg/kg group(group M2),and 0.75 mg/kg group(group M3)30 minutes before anesthesia,40 children in each group.Modified Yale preoperative anxiety scale-short form(mYPAS-SF)was recorded at premedication,parental separation,and immediate induction of anesthesia.Induction compliance checklist(ICC)score,recovery time,extubation time,PACU residence time,pediatric anesthesia emergence delirium scale(PAED)and the modified face,legs,activity,cry and consolability scale(FLACC)30 minutes after operation were also recorded.Results Compared with before taking medication,mYPAS-SF scores in groups M2 and M3 at parental separation and immediate induction of anesthesia were significantly decreased(P<0.05).Com-pared with group M1,mYPAS-SF scores at parental separation and immediate induction of anesthesia and ICC scores at immediate induction of anesthesia were significantly lower in groups M2 and M3(P<0.05),the recovery time,extubation time and PACU resident time in groups M2 and M3 were significantly pro-longed,PAED score was decreased significantly within 30 minutes after operation(P<0.05).Compared with group M2,the awakening time and extubation time in group M3 were significantly prolonged.(P<0.05).Conclusion Oral midazolam 0.5 mg/kg or 0.75 mg/kg 30 minutes before anesthesia can effectively alleviate the preoperative anxiety of children,improve the degree of cooperation in anesthesia in-duction,and reduce the occurrence of postoperative agitation,the recovery time and extubation time pro-longed in children with oral midazolam 0.75 mg/kg.Therefore,an oral solution of midazolam 0.5 mg/kg was a more appropriate dose for preoperative antianxiety regimen in children.

MidazolamChildrenPreoperative anxietyLaparoscopyInguinal hernia

王宣、徐四七、陈永权、居霞、王胜斌

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246003 安徽省安庆市,安庆市立医院麻醉科

皖南医学院第一附属医院麻醉科

咪达唑仑 儿童 术前焦虑 腹腔镜 腹股沟斜疝

2024

临床麻醉学杂志
中华医学会南京分会

临床麻醉学杂志

CSTPCD北大核心
影响因子:2.225
ISSN:1004-5805
年,卷(期):2024.40(5)
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