The Clinical Observation Of Nalbuphine For The Prevention Of Emergence Agitation In Children Undergoing Strabismus Surgery During General Anesthesia

Background and ObjectivesStrabismus is a common ophthalmic disease and one of the most common eye diseases in children.Pediatric ophthalmologic surgery is performed under general anesthesia,and it is a high risk factor for emergence agitation.The duration of pediatric emergence agitation is relatively short and benign,but the harm it caused is considerable.The children’s unconscious body movement can cause the catheter to fall off,the wound to bleeding or cracking,and falling bed.The aim of this study is to observe the effect and safety of nalbuphine in the prevention of emergence agitation in children Undergoing Strabismus Surgery during General Anesthesia.Subjects and methodsSixty cases of children with strabismus surgery were selected,Aged 2⁷years,not limited by gender,weight 10.0²6.0 kg,ASAⅠ^Ⅰlevel,divided into two groups by the random number table method（n=30）:The control group（Group C）and the nalbuphine group（Group N）.Both groups were treated with endotracheal intubation;routine induction of anesthesia with 1.5²mg/kg propofol,0.1mg/kg cisatracurium,0.3⁰.5μg/kg sulfentanil;mechanical ventilation after successful intubation,Maintain P_ETCO₂35⁴5mmHg（1mmHg=0.133kPa）.The anesthesia was maintained with 6¹2mg/（kg.h）propofol,0.1⁰.2μg/（kg.min）refentanyl intravenous pump.At 20 minutes before the end of the surgery,group C were injected with normal saline 5ml;group N were injected with nalbuphine 0.1mg/kg.Record the HR,MAP,SpO₂,the time of extubation,the recovery time and out of the operating room time.Evaluate the rate of the incidence of emergence agitation and the satisfaction of the families of the children after surgery.The incidence of adverse reactions that were respiratory depression,nausea and vomiting and others was recorded.Results1.There was no statistically significant difference in age,weight,operation time,anesthesia time between the two groups（P>0.05）.2.There was no significant difference in HR,MAP and SpO2 between the two groups at each time point（P>0.05）.3.Compared to group C（the PAED score 10.4±3.0）,group N（7.6±2.6）was significantly lower,and incdence of emergence agitation in group N 26.7%was less than that in group C 3.3%,and the difference was statistically significant（P<0.05）.The satisfaction of the parents in the group N for 8.6±1.7 was higher than that in group C for 6.3±1.8,and the difference was statistically significant（P<0.05）.4.Compared to group C（8 cases）the children who coughed when the tracheal tube was removed in group N（4 cases）,but the difference was not statistically significant（P>0.05）.The incidence of nausea and vomiting and respiratory depression was not statistically significant（P>0.05）.There was neither laryngospasm nor bronchial spasm in both groups.ConclusionsChildren undergoing strabismus surgery during general anesthesia before the end of 20 minutes intravenous injection of nalbuphine 0.1mk/kg,can reduce the PAED score,reduce the incidence of emergence agitation,increase the parents’satisfaction with anesthesia.