关键词: 扁桃体腺样体切除术, 舒芬太尼, 疼痛, 躁动, 血流动力学, 家长满意度

Abstract:

Objective To analyze the effect of different doses of sufentanil in pediatric tonsil adenoidectomy （referred to as tonsil surgery）. Methods 111 cases of children who underwent pediatric squamous gland surgery were selected， and the cases were included from January 2023 to October 2024， and the collection site was Ganzhou Maternal and Child Health Hospital， the selected children were divided into the group A， B， and C by randomized numerical table method， each with 37 cases. 0.25 μg/kg of sufentanil was given to group A， 0.30 μg/kg of sufentanil was given to group B， 0.35 μg/kg of sufentanil was given to group C. The perioperative times， the pain and agitation conditions in the early postoperative period （Within 30 min after extubation）， the hemodynamics before the induction of anesthesia （T₀）， the immediate moment of endotracheal intubation （T₁）， the immediate start of the surgery （T₂）， and hemodynamics at extubation （T₃）， the adverse effects during observation and the parental satisfaction at discharge of the three groups were compared. Results The times of extubation， autonomic respiration recovery， awakening and anesthesia recovery room stay were shorter in the group A， B than in the group C （P < 0.05）. Early postoperative period， the scores of face legs activity crying consolability （FLACC） and pediatric anesthesia agitation during awakening （PAED） were lower in the groups B， C than in the group A （P < 0.05）； and the incidence of pain and agitation in the groups B， C （5.41%， 8.11%； 2.70%， 5.41%） was lower than in the group A （40.54%， 45.95%） （P < 0.05）. Compared with that at T0， the mean arterial pressure （MAP） and heart rate （HR） at T₁， T₂， and T₃ were elevated in the group A （P < 0.05）； MAP and HR at T₁， T₂ and T₃ were lower in the groups B， C than in the group A （P < 0.05）. During the observation period， the incidence of choking and coughing in the groups B， C（16.22%， 13.51%） was lower than that in the group A（51.35%） （P < 0.05）； the incidence of nausea and vomiting and drowsiness in the groups A， B （2.70%， 16.22%； 5.41%， 18.92%） was lower than that in the group C （24.32%， 62.16%） （P < 0.05）. At the time of discharge， the parental satisfaction score in the group B was （9.12 ± 0.25）， which was higher than that in the groups A and C ［（7.91 ± 0.33）， （7.93 ± 0.41）］ （P < 0.05）. Conclusions The application of 0.30 μg/kg sufentanil in pediatric squamous gland surgery is more effective， which could shorten the time of each perioperative period， maintain hemodynamic stability， reduce the occurrence of postoperative pain， agitation， choking， nausea and vomiting， and somnolence， and improve the safety， as well as enhance the parental satisfaction of the children.

Key words: tonsil adenoidectomy, sufentanil, pain, agitation, hemodynamics, parental satisfaction