摘要：

目的： 探讨无阿片类药物麻醉和阿片类药物麻醉在小儿全身麻醉下多生牙拔除术中的应用及其镇痛效果与安全性。方法： 选取本院麻醉科于2020年12月—2021年12月接受多生牙拔除术治疗的240例多生牙患儿为研究对象，根据全身麻醉的方案分为阿片类药物麻醉组和无阿片类药物麻醉组，每组各120例，阿片类药物麻醉组采用舒芬太尼进行麻醉，无阿片类药物麻醉组采用七氟烷进行麻醉。比较两组患儿麻醉前、手术前及手术后的心率、收缩压、舒张压，镇痛效果，麻醉时间（开始诱导到停止麻醉给药），自主呼吸恢复时间，苏醒时间，安全性评价。结果： 2组患儿麻醉前、手术前及手术后的心率、收缩压、舒张压比较，差异无统计学意义（P>0.05）；阿片类药物麻醉组麻醉完全的患儿多于无阿片类药物麻醉组，差异有统计学意义（P<0.05）；两组患儿麻醉时间比较，差异无统计学意义（P>0.05）；无阿片类药物麻醉组自主呼吸恢复时间、苏醒时间均短于阿片类药物麻醉组，差异有统计学意义（P<0.001）；无阿片类药物麻醉组患儿的总不良反应发生率低于阿片类药物麻醉组，差异有统计学意义（P<0.05）。结论： 采用无阿片类药物麻醉对患儿进行多生牙拔除术可以维持患儿生命体征稳定，镇痛效果好，不良反应少，安全性高。

关键词: 多生牙拔除术, 无阿片化麻醉, 全身麻醉, 镇痛效果, 安全性

Abstract:

Objective: To investigate the application, analgesic effect and safety of opioid general anesthesia versus opioid-free general anesthesia in extraction of supernumerary teeth in children.Methods: A total of 240 children with supernumerary teeth who underwent tooth extraction in the Department of Anesthesiology of our hospital from December 2020 to December 2021 were selected as the research objects. According to the different general anesthesia schemes, they were divided into opioid anesthesia group and non-opioid anesthesia group, with 120 cases in each group. The opioid anesthesia group was anesthetized with sufentanil and the non-opioid anesthesia group was anesthetized with sevoflurane. The heart rate, systolic blood pressure, diastolic blood pressure, analgesic effect, anesthesia time (from induction to cessation of anesthesia), recovery time of spontaneous breathing, recovery time and safety evaluation were compared between the two groups.Results: There was no significant difference in heart rate, systolic blood pressure and diastolic blood pressure between the two groups before anesthesia, before operation and after operation (P>0.05); The quantity of children with complete anesthesia in opioid anesthesia group were more than those without opioid anesthesia group, the difference was statistically significant (P<0.05); there was no significant difference in anesthesia time between the two groups (P>0.05); the recovery time and recovery time of spontaneous respiration in the non-opioid anesthesia group were shorter than those in the opioid anesthesia group (P<0.001); the total incidence of adverse reactions in children without opioid anesthesia group was lower than that in children with opioid anesthesia group. The difference was statistically significant (P<0.05).Conclusion: The results have shown that extraction of supernumerary teeth in children under opioid free anesthesia can maintain the stability of vital signs, and achieve good analgesic effect, less adverse reactions and high safety.

Key words: extraction of supernumerary teeth, opioid free anesthesia, general anesthesia, analgesic effect, security

中图分类号: 

• R782

• R614.2