瑞芬太尼和异丙酚全凭静脉麻醉在小儿短小手术中的应用

Use of remifentanil-propofol infusion in children total intravenous anesthesia

目的探讨瑞芬太尼复合异丙酚用于小儿短小手术全凭静脉麻醉的有效性、安全性和可控性。方法选择小儿外科择期手术患儿80例,随机分为4组,R1、R2、R3 3组为全凭静脉麻醉组(瑞芬太尼加异丙酚全凭静脉麻醉),C组为对照组,采用静脉吸入复合麻醉。4组均不插管,保留自主呼吸。监测血压、心率、血氧饱和度、手术时间、苏醒时间、听觉诱发电位、血糖。结果4组均达到外科麻醉深度,R2组麻醉效果最好,R1、R2、R3组苏醒快,C组出现1例喉痉挛。结论在小儿短小手术中,选择瑞芬太尼复合异丙酚全凭静脉麻醉,术中血液动力学指标更平稳,术中及术后副作用也相对较少,更安全。

Objective To discuss the efficacy, safety and controllability of total venous anesthesia using remifentanil and propofol in short pediatric operations. Methods 80 undergoing lower abdomen surgery patients were enrolled and randomly allocated to four groups. R1, R2 and R3 groups were given total intravenous anesthesia, and C group was given vena-inhalation anesthesia. BP, HR, ECG, SPO2, operation-time, waked-time, AAI, blood sugar were monitored. Results The anesthesia depth of the four groups was enough for the operations. The anesthesia of R2 group was the best, and the patients in R1, R2, R3 groups waked up earlier. There was only one patient in C group appeared laryn- gospasm. Conclusion Infusion-based anesthesia using remifentanil and propofol is associated with better hemodynamic stability and better recovery profile.