异丙酚联合瑞芬太尼在小儿气管异物取出术中的临床应用

Propofol Combined with Remifentanil on Tracheal and Bronchial Foreign Body Removal in Children

目的：探讨异丙酚联合瑞芬太尼在小儿气管异物取出术中的临床应用效果。方法：纳入86例气管异物患儿,按照随机数字表法分为观察组和对照组,每组43例。观察组：1.0μg/kg瑞芬太尼、1.5mg/kg异丙酚静脉泵入麻醉,对照组：1.0mg/kg氯胺酮、1.0mg/kg异丙酚静脉泵入麻醉。两组均保留自主呼吸,待患儿熟睡后手术开始。术中麻醉维持,观察组：瑞芬太尼以每分钟0.2-0.5mg/kg,异丙酚以每分钟2.0-3.0mg/kg的剂量持续静脉泵入;对照组根据患儿个体麻醉情况,追加氯胺酮。1%丁卡因进行喉部和气管内表面麻醉。置入硬质支气管镜,侧孔连接高频通气。记录手术时间、苏醒时间以及手术中不良反应发生情况;观察置镜条件和置镜次数。结果：观察组患儿手术时间和苏醒时间明显短于对照组,差异具有统计学意义（P〈0.05）。观察组患儿置镜顺利程度和置镜次数均优于对照组,比较具有统计学意义（P〈0.05）,观察组患儿术中不良反应发生明显少于对照组,比较具有统计学意义（P〈0.05）。结论：异丙酚联合瑞芬太尼在小儿气管异物取出术中,麻醉效果满意,不良反应少。

Objective： To investigate the effect of propofol combined with remifentanil on tracheal and bronchial foreign body removal in children. Methods： In 86 cases of tracheal and bronchial foreign body removal in children. Using the method of random number table, the cases were randomly divided into the observation group and control group. Observation group： 1.0μg/kg remifentanil, 1.5mg/kg propofol intravenous pumping anesthesia, control group： 1.0mg/kg of ketamine, 1.0mg/kg propofol intravenous pumping anesthesia. The two groups were spontaneously breathing, to start operation after sleeping. Anesthesia maintain, the observation group： remifentanil to 0. 2 ~ 0. 5mg/kg per minute,propofol 2. 0-3.0mg/kg per minute doses of continuous intravenous pumping; the control group according to individu- al children with additional ketamine. 1% tetracaine throat and trachea surface anesthesia. High frequency jet ventilation was applied in two groups. Record the operation time, wake up of time, and during the operation, adverse reactions oc- curred in the operation situation; observe conditions and frequency of bronchoscope. Results：There was statistic significance in the operation time, reeovery time, conditions and frequency of bronchoscope, the adverse reaction of the patients with the incidence （P〈0. 05）, the observation group were better than the control group. Conclusion： Propofol combined with remifentanil on tracheal and bronchial foreign body removal in children, satisfactory anesthesia effect, less adverse reaction.