The Influence Of Sufentanil As Preemptive Analgesia(PCIA) On Children With Tonsillectomy During Extubation

Objective:The experiment was to study the clinical effects and adverse reactions of using sufentanil in PCIA as preemptive analgesia for children with tonsillectomy or adenotonsillectomy by observing the behaviors of children during extubation and 48 hours after the operations.Comparing to postoperative analgesia,the aim was to find the more effective way to keep children stable during extubation.Method:We chose 60 children randomly in our hospital with ASA?~? at the age of 3~6 who would undergo tosillectomy or adenotonsillectomy.The 60 children were divided into the experimental group and the control group randomly.Each group had 30 patients.Both groups received general anesthesia with the same pre-anesthesia and the same induction and maintenance of anesthesia.HR,NIBP,Sp O2,ECG,PETCO2 and BIS were monitored during the whole surgery.In the experiment group,the PCIA pumps were linked to the patients at 15 minutes before the end of the operation.In the control group,the PCIA pumps were linked to the patients at the end of the operation.The background rate was set at 2ml/h,and the maximum additional dose was set at 0.5ml,and the minimum time to superadditon was set at 15 minutes.All the pumps were removed from the patients after 48 hours.MAP?HR and Sp O2 at entering the operation room,extubation,5 minutes after extubation,10 minutes after extubation and 15 minutes after extubation were recorded.We also recorded the duration of extubation and leaving the PACU after the surgery.The scores of PAED?FLACC and Ramsay were also observed and recorded at 5 minutes?10 minutes and 15 minutes after extubation.We also observed VAS and Ramsay score at 4?8?24?36 hours after the surgery.Adverse reaction such as nausea?vomiting?pruritus?somnolence?respiratory depression and others were recorded too.Results:1.The basic information including age ? height ? weight and the legth of operation of the patients in two groups had no significance differences(P>0.05).2.Through comparing MAP?HR?Sp O2 between two groups,we found there were no statistical differences.(P>0.05).Compared within groups,MAP and HR at the time of extubation were significantly higher(P<0.05).Sp O2 at the time of extubation was significantly lower(P<0.05).After the extubation,there were no significant differences in MAP?HR?Sp O2 between every two points of times.3.The duration of extubation and leaving the PACU after the surgery had no statistically significant differences.4.PAED?FLACC and Ramsay scores of 5 minutes?10 minutes and 15 minutes after extubation of experimental group were significantly different from control groups(P<0.05).The PAED and FLACC scores of experimental group at 5 minutes?10 minutes and 15 minutes after extubation were lower.And The Ramsay score of experimental group was higher at 5 minutes?10 minutes and 15 minutes after extubation.5.VAS and Ramsay scores at 4?8?24?36 hours after the operation had no statistically significant differences from control group.6.The rate of patients who suffered from adverse reaction such as nausea?vomiting?pruritus?somnolence?respiratory depression and others had no statistical differences between two groups.Conclusions :1.Sufentanil PCIA used as preemptive analgesia had the same effect as being used as postoperation analgesia on children with tosillectomy or adenotonsillectomy after the operation.2.Sufentanil PCIA used as preemptive analgesia could make children with tosillectomy or adenotonsillectomy more stable during extubation.