在纤维支气管镜检查中使用艾司他敏对儿童术后负面行为变化的影响

IF 0.4 4区 医学 Q4 PEDIATRICS Iranian Journal of Pediatrics Pub Date : 2023-12-11 DOI:10.5812/ijp-136679
Yu Zhang, Junli Yao, Chen Yang, Li Li
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引用次数: 0

摘要

背景:纤维支气管镜检查是目前临床上最常用的侵入性检查方法。研究目的本研究旨在评估在纤维支气管镜检查过程中使用埃司氯胺酮对儿童术后不良行为改变(NPOBC)发生率的影响。研究方法:90 名接受纤维支气管镜检查的儿童90名接受纤维支气管镜检查的儿童被随机分配到3组:对照组(C组,n = 30)、治疗组1(D1组,n = 30)和治疗组2(D2组,n = 30)。C 组接受气管内表面麻醉和七氟醚吸入,同时静脉注射 5 毫升生理盐水。D1 组接受气管内表面麻醉和七氟烷吸入,同时静脉注射稀释至 5 毫升的 0.5 毫克/千克埃斯卡敏。D2 组接受气管内表面麻醉和七氟烷吸入,并静脉注射稀释至 5 mL 的 0.75 mg/kg 艾司卡胺。结果与 C 组相比,D1 和 D2 组在检查后 1、7、14 和 30 天的 NPOBC 发生率较低(P < 0.05)。D1组和D2组的小儿麻醉后谵妄(PAED)评分低于C组,其中D2组的评分低于D1组(P<0.05)。D1 组和 D2 组的苏醒时间长于 C 组(P < 0.05),其中 D2 组的苏醒时间长于 D1 组。D1 组和 D2 组的脸部、腿部、活动、哭泣和可安慰性(FLACC)评分明显低于 C 组,D2 组的评分低于 D1 组(P < 0.05)。与 C 组相比,D1 组和 D2 组的不良反应发生率较低,D2 组甚至低于 D1 组(P < 0.05)。结论以0.75毫克/千克的剂量使用埃斯卡敏可能会取得更好的临床效果。
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Effect of Esketamine Applied in Fiberoptic Bronchoscopy on Negative Postoperative Behavioral Changes of Children
Background: Fiberoptic bronchoscopy is currently the most commonly used invasive examination method in clinical practice. Objectives: This study aimed to assess the impact of esketamine administration during fiberoptic bronchoscopy on the occurrence of negative postoperative behavioral changes (NPOBCs) in children. Methods: Ninety children undergoing fiberoptic bronchoscopy were enrolled and randomly assigned to 3 groups: the control group (group C, n = 30), treatment group 1 (group D1, n = 30), and treatment group 2 (group D2, n = 30). Group C received intratracheal surface anesthesia and sevoflurane inhalation, along with an intravenous injection of 5 mL of normal saline. Group D1 received intratracheal surface anesthesia and sevoflurane inhalation in addition to an intravenous injection of 0.5 mg/kg of esketamine diluted to 5 mL. Group D2 received intratracheal surface anesthesia and sevoflurane inhalation, with an intravenous injection of 0.75 mg/kg of esketamine diluted to 5 mL. Results: The incidence of NPOBCs was lower in groups D1 and D2 compared to group C at 1, 7, 14, and 30 days after the examination (P < 0.05). The pediatric anesthesia emergence delirium (PAED) scores were lower in groups D1 and D2 than in group C, with group D2 scoring lower than group D1 (P < 0.05). Groups D1 and D2 had a longer time to awaken than group C (P < 0.05), with group D2 having a longer time than group D1. The face, legs, activity, cry, and consolability (FLACC) scores in groups D1 and D2 were significantly lower than in group C, and group D2 had a lower score than group D1 (P < 0.05). The incidence of adverse reactions was lower in groups D1 and D2 compared to group C, and the rate was even lower in group D2 than in group D1 (P < 0.05). Conclusions: Administration of esketamine at a dose of 0.75 mg/kg may yield better clinical outcomes.
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来源期刊
CiteScore
0.90
自引率
20.00%
发文量
75
审稿时长
6-12 weeks
期刊介绍: Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.
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