雷米芬太尼和丙泊酚在小儿结肠镜检查中的临床应用

Clinical Application of Remifentanil and Propofol in Coloscopy for Children

为观察雷米芬太尼和丙泊酚在小儿结肠镜检查中的应用，将60例ASAⅠ～Ⅱ级行结肠镜检查的小儿随机分为A、B、C3组，每组20例。A组静脉缓注2mg／kg的丙泊酚；B组静脉缓注雷米芬太尼0．6μg／kg后1min静脉缓注1．8mg／kg的丙泊酚；C组静脉缓注雷米芬太尼0．6μg／kg后1min静脉缓注1．8mg／kg的丙泊酚；分别记录术前、术中、术后2min的血压（BP）、心率（HR）、脉搏血氧饱和度（SPO2）、麻醉药用量、苏醒时间、检查时间和不良反应。结果显示，各组术前、术中、术后2min的BP、HR、SPO2变化无差异（P〉0．05）。C组丙泊酚用量（68．8±24．3）mg低于B组（92．8±23．1）mg及A组（109．8±43．3）mg（P〈0．05），术后C组的苏醒时间（2．1±1．3）min少于B组（3．8±2．3）min及A组（12．8±5．6）min（P〈0．05）。结果表明，雷米芬太尼和丙泊酚联合应用，使患儿在结肠镜检查中无痛苦，安全、舒适。

The objective of this study was to observe the efficacy of remifentanil and propofol used in coloscopy for children. The 60 pediatric patients to be subjected to coloscopy,who had been diagnosed as ASA Ⅰ- Ⅱ degree,were divided into A,B, C groups randomly （20 cases, each groups）. A group was slowly administered injection with 2 mg/kg of propofol intravenously;B group with 0.6 μg/kg of remifentanil firstly,later 1 min with 1.8mg/kg propofol. Then for the three groups pre-,during and post-operative later 2 min data of BP, HR, SPO2, anesthetic dose, recovering time from the anesthesia, examination time, etc were recorded,and their adverse reaction was recorded. As results, for all the three groups the changes of pre-, during and post-operative later 2 min BP, HR, SPO2 had no difference（ P 〉0.05）;in anesthetic dose of propofol C group was significantly lower than B and A group（68.8±24.3）mg vs（92.8±23.1）mg, （109.8 ±43.3）mg; （ P 〈0.05） ;in the postoperative recovering time C group was less than B and A groups（2.1±1.3）min vs（3.8±2.3）min, （12.8±5.6）min; （ P 〈0.05）. Above results show that remifentanil combined with propofol could be painless,safe and comfortable in coloscopy for children.