舒芬太尼复合氯胺酮在幼儿支气管异物取出术中的应用

Application of Sufentanil Combined Ketamine in Removal of Foreign Bodies from Bronchi in Children

目的:探讨舒芬太尼复合氯胺酮在幼儿支气管异物取出术中应用的可行性及安全性。方法:42例需行支气管异物取出术的患儿随机分为舒芬太尼(S)组与芬太尼(F)组,两组均在氯胺酮诱导后行气管内插管控制呼吸,S组静注并持续泵入舒芬太尼,F组分次静注芬太尼,采用纤维支气管镜钳(套)取异物。记录两组不同时间点HR、SpO2、平均动脉压(MAP)及镜检满意度、自主呼吸恢复时间(Tr)、出室时间(To)。结果:Tr、To S组明显短于F组(P<0.01),镜检满意度优于F组(P<0.05);F组HR、MAP插镜后均比插管后提高(P<0.05),S组各时间点HR、MAP比无统计学意义。结论:舒芬太尼复合氯胺酮在支气管异物取出术中的应用良好,提高了手术安全性。

Objective： To investigate the feasibility and safety of application of sufentanyl combined ketamine in removal foreign bodies from bronchi in children. Methods： Forty-two children undergoing removal of foreign bodies from bronchi were randomly assigned into sufentanil group and fentunyl group. Anesthesia was induced with ketamine, and maintained with sufentanil by continuing intravenous injection in the sufentanil group, with fentunyl by intermittent intravenous injection in the fentunyl group. The bronchfiberscopy forcep was applied to remove foreign bodies. HR、 SpO2, MAP between two groups were recorded at different time points. The degree of satisfaction of operation, spontaneously breathing recovery time（Tr）, out room time（To）were recorded between two groups. Results： Tr, To in the sufentanil group were lower than those in the fentunyl group（ P 〈 0.01）, and the degree of satisfaction of operation was better（ P 〈 0.05）, HR, MAP after bronchtiberscopy inset were higher than those after tracheal intubation in the fentunyl group（ P 〈0.05）, but those were no diference at different time points in the sufentanil group. Conclusion： The application of sufentanyl combined ketamine in removal foreign bodies from bronchi in children is feasibe and safe.