两种全麻方式用于小儿扁桃体和增殖体切除术的比较

Comparison of two general anesthesia techniques in children with adenotonsillectomy

目的比较七氟烷瑞芬太尼静吸复合麻醉和异丙酚瑞芬太尼全凭静脉麻醉两种麻醉方式用于小儿扁桃体和增殖体切除术对术中维持、术后恢复情况的影响。方法40例2～6岁择期行扁桃体和增殖体切除术患儿随机分为两组（n=20）：异丙酚瑞芬太尼全凭静脉麻醉组（P-R组）和七氟烷瑞芬太尼静吸复合麻醉组（S-R组），分别以异丙酚瑞芬太尼全凭静脉或七氟烷瑞芬太尼静吸复合维持麻醉。观察并比较两组患儿诱导前（T1）、插管时（T2）、手术即刻（T3）、手术15min（T4）、手术30min（T5）及清醒拔管（T6）血流动力学变化；记录手术时间、清醒及拔管时间，并观察术后呕吐、呛咳及躁动等不良反应。结果两组患儿术中血流动力学稳定。两组均无严重不良反应发生。结论七氟烷瑞芬太尼静吸复合麻醉和异丙酚瑞芬太尼全凭静脉麻醉均适用于小儿扁桃体和增殖体切除术。

Objective To compare the maintenance and postoperative recovery pattern of sevoflurane inhalation supplemented with remifentanil infusion and propofol-remifentanil total intravenous anesthesia in children with adenotonsillectomy. Methods Forty children aged 2-6 years with adenotonsilleetomy were randomly allocated to 2 groups, including group S-R and group P-R. In group S-R, the anesthesia was maintained with sevoflurane inhalation supplemented with remifentanil and in group P-R, the anesthesia was maintained with intravenous infusion of propofol and remifentanil. The haemodynamics changes were checked at different time point. Extubation time, surgery time, consciousness recovery time and adverse events such as vomit and restlessness were evaluated. Results The haemodynamics conditions of the two groups were stable. No adverse events happened in both two groups. Conclusions Sevoflurane inhalation supplemented with remifentanil infusion and propofol-remifentanil total intravenous anesthesia were equally suitable for adenotonsillectomy in children.