瑞芬太尼复合异丙酚用于小儿短小手术患儿麻醉的效果分析

Clinical observation of remifentannil combined propfol in infant anesthesia for minor surgeries

目的:探讨小儿短小手术患儿应用瑞芬太尼复合异丙酚麻醉的临床效果。方法:选择需做小儿短小手术的患儿48例,ASAⅠ～Ⅱ级,年龄4～12岁,按年龄和麻醉药物分为4组(n=12):A组4～7岁,Aa组8～12岁,瑞芬太尼复合异丙酚麻醉;B组4～7岁,Bb组8～12岁,氯胺酮复合异丙酚麻醉。A和Aa组静脉泵入静脉泵入异丙酚4mg.kg-1.h-1和瑞芬太尼0.1μg.kg-1.min-1。B和Bb组异丙酚4mg.kg-1.h-1和氯胺酮3mg.kg-1.h-1。结果:4组SP、DP、HR、RR均较麻醉前降低但在正常范围(P<0.05);与B和Bb组比较,A和Aa组RR降低,术中体动和术后躁动发生率降低,苏醒时间和意识恢复时间缩短(P<0.05)。结论:瑞芬太尼复合异丙酚用于小儿短小手术患儿可产生良好的麻醉效果,且具有术中生命体征稳定、血液动力学平稳,不良反应发生率低及术后苏醒迅速等优点。

Objective： To evaluate the clinical efficacy and safety of remifentanil combined propfol in infant anesthesia for minorsurgeries. Methods： 48 infants undergoing minor surgeryies with were randomly divided into four groups, 12 patients each group. The A group from 4 -7 year old and Aa group from 8 - 12 year old were anesthetized by remifentanil combined with propfol. The B group from 4 -7 year old and Bb group from 8 - 12 year old were anesthetized by remifentanil combined with ketamine. Anesthesia was maintained with 0.2 μg · kg^-1 · min^-1 remifentanil combined with 4 mg · kg^-1 · min^-1 propfol micropump infusion in group A and Aa, but in group B and Bb with 3 mg · kg^-1 · min^-1 ketamine micro pump infusion. Hemodynamic parameters were observed continuously. Recovery time and anesthesia effects （evaluated by surgeon） were also analyzed. Results： SP, DP, HR and RR decreased after anesthesia, but all was in normal range. The RR and the time of analepsia and consciousness recovery of group A and Aa significantly decreased than group B and Bb （P 〈 0.05 ）. The incidence rate of body action in operation and restlessness after operation of group A and Aa significantly decreased than group B and Bb （P 〈 0.05）. Conclusion ：Remifentanil combined with propfol in infant anaesthesia for minor surgeries, has the advantages such as stable vital signs during operation, rapid awake and low rate of adreuse reactions.