中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (4): 298-301.doi: 10.12007/j.issn.0258-4646.2017.04.003

• 论著 • 上一篇    下一篇

经皮穴位电刺激对小儿电子耳蜗植入术苏醒期躁动的影响

陈方园,杨悦,孙雪晨,黑笑凡,马铃   

  1. 中国医科大学附属盛京医院麻醉科,沈阳 110004
  • 收稿日期:2016-10-13 出版日期:2017-04-30 发布日期:2017-04-19
  • 通讯作者: 马铃 E-mail:maling27@hotmail.com
  • 作者简介:陈方园(1992 -),女,医师,硕士 .
  • 基金资助:
    国家自然科学基金(81302534)

Effect of Transcutaneous Electrical Acupoint Stimulation on Emergence Agitation in Children Undergoing Cochlear Implantation

CHEN Fangyuan,YANG Yue,SUN Xuechen,HEI Xiaofan,MA Ling   

  1. Department of Anesthesiology,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2016-10-13 Online:2017-04-30 Published:2017-04-19

摘要: 目的 研究经皮穴位电刺激对先天性聋哑小儿电子耳蜗植入术术后躁动的影响。方法 将 60 例行小儿电子耳蜗植入术患儿(1~4 岁)随机均分为 2 组,实验组(T 组)采用经皮穴位电刺激辅以静吸复合麻醉,对照组(C 组)不接受穴位刺激。记录麻 醉时间、手术时间、围术期血流动力学变化、停药后拔管时间、麻醉恢复室(PACU)停留时间,观察苏醒期躁动及恶心呕吐等情 况。结果 2 组患儿年龄、性别、体质量、手术时间、PACU 停留时间比较,差异无统计学意义。T 组在手术开始后 30 min、手术结 束、拔管即刻及拔管后 5 min 时平均动脉压及心率均低于同时刻 C 组,差异有统计学意义(P < 0.05);T 组拔管即刻及拔管后 30 min 内各时点面部疼痛表情量表(FPS-R)和特殊患者疼痛评估量表(FLACC)小儿疼痛评分及小儿麻醉苏醒期烦躁量表(PAED) 躁动评分均低于对照组,差异有统计学意义(P < 0.05);T 组拔管时间、麻醉时间及术后恶心呕吐(PONV)的发生率均低于对照组,差异有统计学意义(P < 0.05)。结论 经皮穴位电刺激辅助静吸复合麻醉能明显减轻双耳先天性重度神经性感音性聋小儿 术后躁动,术中具有一定的控制性降压作用,缓解苏醒期血流动力学剧烈变化,缩短拔管时间,减少 PONV 的发生。

关键词: 经皮穴位电刺激, 电子耳蜗植入术, 控制性降压, 术后躁动, 婴幼儿

Abstract: Objective To study the effect of transcutaneous electrical acupoint stimulation(TEAS)on emergence agitation in children undergoing cochlear implantation. Methods Sixty patients(age range,1-4 years)scheduled to undergo pediatric cochlear implantation were enrolled and randomized into the TEAS group(group T,n = 30)that received continuous TEAS and the control group(group C,n = 30)that did not receive TEAS. Anesthesia time,operation time,change in blood flow dynamics during the perioperative period,extubation time,and PACU stay time were recorded. The incidence of emergence agitation and postoperative nausea and vomiting(PONV)was monitored. Results No significant intergroup differences were observed in age,sex,weight,operation time,and PACU stay time(P > 0.05). The MAP and HR in group T were lower than those in group C at different time points such as 30 min after the start of surgery,the end of the surgery,the extubation and 5 min after extubation,and the difference was statistically significant(P < 0.05). The FPS-R,FLACC,and PAED scores in group T were lower than those in group C at different time points within 30 min after extubation(including the time of extubation),and the difference was statistically significant(P <0.05).Extubation time,anesthesia time,and incidence of PONV were lower in group T than in group C,and the difference was statistically significant(P < 0.05). Conclusion TEAS combined with general anesthesia significantly reduces the incidence of emergence agitation in children undergoing surgery for congenital hearing loss;it also helps control hypotension,relieve dramatic hemodynamic changes during the waking period, and reduce the incidence of PONV.

Key words: transcutaneous electrical acupoint stimulation, cochlear implantation, controlled hypotension, emergence agitation, infants and young children

中图分类号: 

  • R614.2
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