瑞芬太尼复合异丙酚喉罩麻醉在小儿射频消融术中应用研究

The study on the application of remifentanil combined with propofol in general anesthesia using laryngeal mask airway during pediatric cardiac catheterization with radio frequency catheter ablation

目的观察瑞芬太尼复合异丙酚喉罩全麻用于小儿经导管心内射频消融术中可行性和临床效果。方法选择ASAⅠ～Ⅱ级,介入治疗的经导管心内射频消融患儿48例,随机分为2组,每组24例,经快速诱导后分别插入喉罩(A组)和气管导管(B组)。观测并比较2组患儿血流动力学变化及与通气情况,并观测术中不良反应。结果B组平均动脉压(MBP)、心率(HR)与气管插管前比较有统计学意义(P<0.05),2组间置入喉罩与气管插管后MBP、HR、血氧饱和度(SpO2)比较有统计学意义(P<0.05)。B组MBP、HR与拔除气管插管前比较有统计学意义(P<0.05),2组间拔除喉罩与气管插管后MBP、HR、SpO2比较有统计学意义(P<0.05)。结论患儿对喉罩插入的耐受性较好,反应小,对心脏传导系统无影响。瑞芬太尼复合异丙酚喉罩麻醉用于儿童射频消融术可行且安全有效。

Objective To observe the feasibility and validity of remifentanil combined with propofol in general anesthesia using LMA during pediatric cardiac catheterization with radio frequency catheter ablation. Methods 48 ASA Ⅰ-Ⅱ children who underwent cardiac catheterization with radio frequency catheter ablation were randomly divided into two groups： group LMA（A） and group Intubation（B）, In both groups, the change of hemodynamic and ventilations were compared, and the untoward reaction was observed in the operation. Results Mean arterial pressure and heart rate at the time of intubation and extubaqtion were significantly increased in group B, as compared with those in group A （P〈0.05）. There were significant differences in the changes of MBP, HR, SpO2 after the time of intubation and extubation（P〈0.05）. Conclusion Using LMA has better tolerance and lower reaction for patients, especially no affection on cardiac conduction systems. It is safe and effective to use LMA, as compared with using tracheal intubation with remifentanil and propofol in general anaesthesia during pediatric cardiac catheterization with radio frequency catheter ablation.