曲马多与芬太尼预注对小儿全麻苏醒期的影响

The Effects of Tramadol Combined with Fentanyl on Recovery from Remifentanil-propofol Anesthesia in Children

目的:观察曲马多与芬太尼联合使用对小儿瑞芬太尼一丙泊酚全麻苏醒期的影响。方法:45例择期行扁桃体和腺样体切除术的患儿,随机分为三组,每组15例。麻醉维持均选用瑞芬太尼与丙泊酚持续输注。诱导插管后,C组静注生理盐水2 mL,T组与T-F组均注入曲马多2 mL/kg,同时T-F组手术结束前10 min静注芬太尼lμg/kg。记录术毕患儿自主呼吸恢复时间、拔管时间、离室时间及客观疼痛不适评分(OPDS)、躁动评分、恶心、呕吐,呼吸抑制等不良反应。结果:T-F组自主呼吸恢复时间、拔管时间均较C组和T组延长(P<0.01),但离室时间三组差异无显著意义。拔管后,OPDS及躁动评分C组>T组>T-F组(P<0.05);躁动发生率C组>T组>T-F组,其中T组、T-F组与C组比较差异有显著性(P<0.05)。结论:曲马多与芬太尼联合应用,对于预防小儿瑞芬太尼一丙泊酚全麻苏醒期躁动、哭闹安全有效。

Objective To observe the effects of intravenous tramadol and fentanyl on the emergence from remifentanil-propofol anesthesia in children.Methods Forty five children,scheduled for adenotonsillectomy,were randomly divided into 3 groups with 15 patients each.All patients were given remifentanil and propofol for anesthesia maintenance.Following intubation,normal saline 2ml were infused in group C,tramadol 2 mg/kg in group T and group T-F.At 10 min before the end of anticipated surgery,group T-F received fentany...