瑞芬太尼在小儿上肢骨折手术麻醉中的应用

Application of remifentanil in the surgery for upper limb fracture in children

目的 研究瑞芬太尼联合神经阻滞用于患儿上肢骨折手术麻醉的可行性.方法 选择40例4～10岁的上肢骨折患儿,分为观察组和对照组.基础麻醉后行神经阻滞.观察组术中泵注瑞芬太尼辅助镇痛,初始剂量为0.05μg·kg^-1·min^-1,随后根据患儿的疼痛程度调整泵注剂量.对照组静注氯胺酮加强镇痛.手术结束前10 min静注曲马朵2 mg/kg.比较两组麻醉效果.结果 所有患儿顺利完成手术,术中元呼吸抑制等情况发生,观察组患儿苏醒时间[（14.0±4.8）min]明显比对照组[（30.4 4±10.3）min]短（t=6.588,P＜0.01）,术后患儿无恶心、呕吐、烦躁等不良反应发生.结论 瑞芬太尼联合神经阻滞可安全使用于患儿短时手术麻醉,可缩短患儿苏醒时间.

Objective To study the application of remifentanil combined with brachial plexus block using in the operation of children with upper limb.Methods A total of 40 children,aged 4～10 years,undergoing arm-fracture operation,breathing oxygen with opening veil,were randomly divided into two groups.The children were administered basal anesthesia before brachial plexus block.During the operation,the study group（n=20）was infused remifentanil,the initial rate was 0.05μg·kg^-1·min^-1,and the control group was infused ketamine to reinforce the analgesia.Results All patients finished the surgery safely.In study group,children recovery time[（14.0±4.8）min]Was more quickly than that of control group[（30.4±10.3）min]（t=6.5 88,P〈0.01）.Conclusion Remifentanil could efficiently assistant brachial plexus block in the operation of children with upper limb.