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瑞芬太尼复合异丙酚在小儿短小手术麻醉中的临床观察 被引量:19

Clinical observation of remifentannil combined propfol in infant anesthesia for minor surgeries
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摘要 目的观察瑞芬太尼复合异丙酚用于小儿短小手术的麻醉效果。方法选择需做短小手术的患儿60侧,ASAⅠ~Ⅱ级,随机分为两组,每组30例,Ⅰ组为静脉单次推注氯胺酮2mg/kg,瑞芬太尼0.025~0.100μg·kg^-1·min^-1复合异丙酚60~200μg·kg^-1·min^-1持续静脉泵注维持组,Ⅱ组为静脉单次推注氯胺酮2mg/kg,氯胺酮10~25μg·kg^-1·min^-1持续静脉泵注维持组。记录患儿术中心率(HR)、脉搏血氧饱和度(SpO2)、平均动脉压(MAP),术后苏醒时间和术后恶心呕吐、精神症状(恶梦、幻觉、错视、哭闹等)等不良反应。结果两组患儿SpO2均较平稳,但Ⅰ组HR较术前明显减慢(P〈0.05),MAP波动较小(P〉0.05),而Ⅱ组HR和MAP较术前明显增加(P〈0.05);Ⅰ组术后麻醉苏醒明显快于Ⅱ组(P〈0.05);Ⅰ组术后恶心呕吐、精神症状等不良反应发生率比Ⅱ组低(P〈0.05)。结论瑞芬太尼复合异丙酚用于小儿短小手术的麻醉,具有术中生命体征稳定、患儿苏醒快、不良反应发生率低等优点。 Objiective To evaluate the clinical efficacy and safety of remifentanil combined propfol in infant anesthesia for minor surgeries. Methods Sixty ASA Ⅰ-Ⅱ infants undergoing minor surgeryies were randomly divided into two groups, 30 patients each group. All patients received an intravenous injection of 2mg/kg ketamine before skin incisions. Anesthesia was maintained with 0. 025-0. 100μg·kg^-1·min^-1 remifentanil combined with 60 200μg·kg^-1·min^-1 propfol micro-pump infusion in group Ⅰ , but in group Ⅱ with 10-25μg·kg^-1·min^-1 ketamine micro-pump infusion. Hemodynamic parameters were observed continuously. Recovery time and anesthesia effects(evaluated by surgeon) were also analyzed. Results HR significantly decreased than baseline in group Ⅰ (P〈0. 05) ; HR and MAP significantly increased in group Ⅱ than baseline. The recovery time was significantly shorter in group Ⅰ than in group Ⅱ (P〈0.05) . The incidence of side effects was lower in group Ⅰ than in group Ⅱ (P〈0.05). Conclusion Remifentanil combined with propfol in infant anaesthesia for minor surgeries,has the advantages such as stable vital signs during operation,rapid awake and low rate of adreuse reactions.
出处 《重庆医学》 CAS CSCD 北大核心 2009年第6期683-684,共2页 Chongqing medicine
关键词 瑞芬太尼 异丙酚 小儿短小手术 麻醉 remifentannil propfol fas-track infant operation anesthesia
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