异丙酚加芬太尼辅助硬膜外麻醉在小儿阑尾手术中的应用

The clinical application of propofol combined with fentanyl to assist epidural anesthesia in pedo-appendix intraoperative

目的:研究异丙酚加芬太尼辅助硬膜外麻醉在小儿阑尾手术中的应用,并与咪唑安定加氯胺酮进行比较。方法:将60例阑尾炎患儿随机分为两组,Ⅰ组采用异丙酚加芬太尼,Ⅱ组采用咪唑安定加氯胺酮,分别记录麻醉前、麻醉后l、5、10、15min的RR(呼吸频率)、HR(心率)、Sp02(氧饱和度)、MAP(平均动脉压)、术后清醒时间(睁眼和清楚应答)、术后24h内恶心、呕吐的发生率。结果:两组麻醉后1、5、l0、15min,HR、RR变化有显著性差异(P<0.05),SpO2、MAP无显著差异,Ⅰ组术后无躁动,恶心、呕吐1例,Ⅱ组术后躁动4例,恶心、呕吐6例。结论:异丙酚加芬太尼辅助硬膜外麻醉在小儿阑尾手术中比氯胺酮加咪唑安定更具优越性。

Objective：To study the clinical application of propofol combined with fentanyl to assist epidural anesthesia in pedo-appendix intraoperative, and compared with midazolam combined with ketamine.Methods：To divide the sixty appendicitis children into two groups, propofol combined with fentanyl and midazolam combined with ketamine, record the 1 min, 5 min, 10 min, 15 min RR,HR, SpO2,MAP, after-operative consciousness time ,the rate of nausea and vomitory in the foreanesthesia and after-anesthesia.Results： The 1,5,10,15 min RR and HR in the after-anesthesia of th two groups indicated significant difference （P〈0.05）, SpO2 and MAP indicated no significant difference. There has been no restlessness in the group of propofol combined with fentanyl after operation, but four in the group of midazolam combined with ketamine. The rate of nausea and vomitory of the two groups were one and six. Conclusion：Propofol combined with fentanyl to assist epidural anesthesia in pedo-appendix intraoperative indicate more superiority than midazolam combined with ketamine.