瑞芬太尼复合丙泊酚在小儿胃镜检查中的应用

Propofol and remifentanii for deep sedation in children undergoing gastroscopy

目的评价瑞芬太尼复合丙泊酚用于小儿胃镜检查的安全性和有效性。方法选择80例2～10岁行胃镜检查的患儿,随机分成两组,瑞芬太尼组(R组):瑞芬太尼1μg/kg复合丙泊酚2.5mg/kg;芬太尼组(F组):芬太尼1μg/kg复合丙泊酚2.5mg/kg。术中间断推注丙泊酚维持麻醉。记录患儿意识消失时间、术后苏醒时间、苏醒期不良反应及丙泊酚用量;呼吸和血流动力学变化。结果所有80例患儿均完成了胃镜检查。R组苏醒时间较F组明显缩短,R组与F组相比丙泊酚用量减少(P<0.05);F组与R组比较平均动脉压(MAP)较基础值明显降低,R组与F组呼吸暂停发生率分别为8%和22%(P<0.05)。结论瑞芬太尼与丙泊酚联合用于小儿胃镜检查是安全、有效的。

Objective The aim of this study was to evaluate the safety and efficacy of a combination of propofol and remifentanil deep sedation in spontaneously breathing children aged 2 to 10-year-old undergoing gastroscopy.Methods 80 children undergoing gastroscopy were randomly allocated into two groups.In the remifentanil group（R group）anesthesia was induced with remifentanil 1μg/kg and propofol 2.5mg/kg,whereas in the fentanyl group（F group）was fentanyl 1μg/kg and propofol 2.5mg/kg,and was maintained with propofol when needed.The following were recorded and compared in the two groups：①the time of unconsciousness,recovery time from anesthesia,the side effects during anesthesia and recovery and total doses of propofol;②hemodynamic and respiratory changes during anesthesia.Results The time of unconsciousness,recovery time from anesthesia at group R was significantly shorter compared with group F;The total doses of propofol used were less at group R than F group（P0.05）.The MAP at group F was depressed significantly.The incidence of apnea at group R and F were 8% and 22%（P0.05）.Conclusion The combination of remifentanil and propofol in children aged 2 to 10-year-old undergoing gastroscopy can be considered safe,effective and acceptable.