瑞芬太尼和芬太尼用于小儿先天性心脏病麻醉的比较

Remifentanil for fast track paedeatric cardiac anesthesia

目的观察瑞芬太尼用于小儿先天性心脏病手术的麻醉效应及术后恢复情况。评价瑞芬太尼在小儿快通道心脏手术中的应用价值。方法择期行房间隔缺损（ASD）或室间隔缺损（VSD）修补术患儿30例,ASAⅠ-Ⅱ级,随机分为瑞芬太尼组（R组）和芬太尼组（F组）,分别于不同时间记录血流动力学参数,观察术后机械通气时间及拔管时间。结果与F组相比,R组在术中各时点血流动力学参数差异无统计学意义（P〉O.05）。但是拔管时间及术后在ICU逗留时间R组较F组显著缩短（P〈0.05）。结论瑞芬太尼能保持术中血流动力学的稳定,有效抑制应激反应,术后能早期拔管,适用于小儿心脏手术快通道麻醉。

Objective To evaluate the use of remifentanil analgesia in pediatric undergoing cardiac surgery with cardiopulmonary bypass.Methods 30 ASA Ⅰ-Ⅱ pediatric patients with atrial septal defeet or simple ventricular septal defect were randomly divided into two groups：remifentanil group（group R）and fentanyl group（group F）.The hemodynamic and stress hormone changes were recorded perioperatively.The extubation time and duration in ICU were also recorded.Results There was no significant difference between the two groups on hemodynamic parameters and blood level of stresshormone at the same time points（P〉0.05）.Tracheal extubation in group R was earlier than that in group F（P〈0.05）.Duration in ICU in group R was shorter than that in group F（P〈0.05）.Conclusion Remifentanil could be safely and effectively used for fast track cardiac anesthesia in children with stable hemodynamics,effective inhibition of stress hormones and early extubation.