瑞芬太尼应用于婴儿麻醉的临床研究

Clinical research of remifentanil-based anesthesia in infant

目的 观察婴儿骶管麻醉复合小剂量瑞芬太尼的临床效果.方法 选取美国麻醉学会分级Ⅰ～Ⅱ级腹部手术的婴儿120例,年龄3个月～1岁,完全随机分为骶管麻醉复合小剂量瑞芬太尼加丙泊酚组（A组）及骶管麻醉复合丙泊酚组（B组）,每组60例.观察2组麻醉前、麻醉后、切皮时、术中探查、关腹、缝皮时、术毕时的心率、血压、血氧饱和度的变化,记录术毕停药后患儿苏醒时间,并观察术后恶心、呕吐的发生率,比较麻醉效果.结果 A组与B组相比,切皮探查时,A组比B组循环更稳定,苏醒时间[A组（8.7±3.4）h,B组（6.1±2.9）h]和术后恶心、呕吐的发生情况（A组2例,B组3例）差异无统计学意义.麻醉效果：A组优58例,良2例;B组优52例,良7例,差1例.结论 骶管麻醉复合小剂量瑞芬太尼加丙泊酚用于婴儿下腹部及会阴部手术具有镇痛完善,镇静满意,血流动力学更稳定,操作简便有效,术后并发症少的特点,是安全可行的.

Objective To observe the clinical effect of sacral block combined with small doses of remifentanil applied in infant. Methods Totally 120 infant patients with abdominal surgery operative aged 3 months to 1 years old were randomly divided into two groups： groupA had sacral block combined with small doses of remifentanil and propofol; group B had sacral block combined with propofol. Obeservation data included the changes of heart rate and blood pressure and oxygen saturation of blood before and after anesthesia, the beginning of incision of skin, exploration during the operation, suture of skin, at the end of surgery, the time of recovery and the rate of nausea and vomiting. Results Compared with groupB, the circulatory system of Group A was more stable at the beginning of incision of skin and the exploration. There were no significant difference of the time of recovery, the rate of nausea and vomiting. Conclusion Sacral block combined with small doses of remifentanil and propofol applied in infant in lower abdomen and perineal surgery is simple and effective, safe and feasible with less complications.