舒芬太尼用于儿童全耳再造术后观察

Observation of sufentanil in children after the auricle reconstruction

目的:观察持续泵注不同剂量舒芬太尼复合吸入不同浓度七氟烷用于全耳再造术,比较各组患儿术后麻醉恢复质量。方法:择期行全耳再造术患儿60例,ASAⅠ级,随机分为四组(n=15)。A、B组:舒芬太尼持续泵注0.1μg/(kg·h)复合吸入1.7%、2.2%七氟烷维持麻醉;C、D组:舒芬太尼持续泵注0.15μg/(kg·h)复合吸入1.7%、2.2%七氟烷维持麻醉。分别观察四组术后血流动力学指标(MAP、HR)、BIS值、镇静(Ramsay)、谵妄(RS)及镇痛(VAS)评分。结果:A、B组术后MAP、HR高于基础值(P﹤0.05);C、D组术后MAP、HR与基础值比较差异无显著性(P﹥0.05)。C组镇静评分满意比例较高,与其他三组比较差异有显著性(P﹤0.05)。B组谵妄评分较高,与其他三组比较差异有显著性(P﹤0.05)。A、B组镇痛评分较高,与C、D组比较差异有显著性(P﹤0.05)。D组术后BIS值较低,与其他三组比较差异有显著性(P﹤0.05)。结论:持续泵注舒芬太尼0.15μg/(kg·h)复合吸入1.7%七氟烷维持麻醉适于儿童全耳再造术,有较高麻醉恢复质量。

Objective To observe the effects of pump-infusion of sufentanil in two dosages combined with two concentrations of sevoflurane inhalation for children undergoing auricular reconstruction, and to evaluate their hemodynamics （MAP, HR） and BIS in recovery from anesthesia, as well as sedative-analgesia in recovery from anesthesia. Methods Sixty children undergoing auricular reconstruction were randomly divided into four groups （n = 15）. Anesthesia was maintained with sufentanil at 0.1μg/（kg·h） and 1.7% sevoflurane inhaled in Group A wheras 2.2% sevoflurane inhaled in Group B; with sufentanil at 0.15 μg/（kg.h） and 1.7% sevoflurane inhaled in group C wheras 2.2% sevoflurane inhaled in group D. Parameters of hemodynamics （MAP, HR）, BIS, Ramsay scores, RS scores, and VAS scores were recorded. Results In group A and B, the parameters of hemodynamics （MAP, HR） were all higher than basal parameters in recovery from anesthesia （P 〈 0.05）, wheras there was no difference in group C and D （P 〉 0.05）. In group C, there were more stable hemodynamics, satisfactory sedative-analgesia among the four groups （P 〈 0.05）. In group B, the RS scores were higher than groups A, C and D （P 〈 0.05）. As to VAS scores, group A and B were higher than group C and D （P 〈 0.05）. Group D had less BIS score than the other groups （P 〈 0.05）. Conclusion Anesthesia maintained with sufentanil at 0.15 μg/（kg·h） and 1.7% sevoflurane inhaled is more suitable for children undergoing auricular reconstruction which had more satisfactory sedative-analgesia and high quality of recovery from anesthesia.