瑞芬太尼联合丙泊酚在小儿扁桃体腺样体切除手术麻醉中的应用

The application of remifentanil combined with propofol in the anesthesia of adenoidectomy and tonsillectomy in children tonsil

目的探讨瑞芬太尼联合丙泊酚在小儿扁桃体腺样体切除手术麻醉中的应用效果。方法回顾性分析82例接受扁桃体腺体样切除手术治疗患儿的临床资料,全部患儿均常规应用咪达唑仑、丙泊酚和维库溴铵进行麻醉诱导,其中40例患者加用芬太尼(对照组),42例患者加用瑞芬太尼(观察组)。比较两组各时间点平均动脉压(MAP)、心率(HR)水平变化以及麻醉后恢复情况。结果观察组T1、T2和T3时间点的MAP和HR水平均低于对照组,差异具有统计学意义(P<0.05);观察组呼吸恢复时间、睁眼时间和拔管时间均短于对照组,差异具有统计学意义(P<0.05)。结论瑞芬太尼联合丙泊酚在小儿扁桃体腺样体切除手术麻醉中的应用效果明显,可使患儿机体血流动力学保持稳定,苏醒速度快且呼吸平稳。

Objective To explore the effect of remifentanil combined with propofol in the anesthesia of adenoidectomy and tonsillectomy in children. Methods A retrospective analysis of 82 cases of children who had adenoidectomy and tonsillectomy was done. Their clinical data were summarized. All children were used midazolam,propofol,and vecuronium bromide routinely in anesthesia induction,and 40 patients with fentanyl（control group）,42 patients with remifentanyl（observation group）. The changes of mean artery pressure（MAP）and heart rate（HR）level and the recovery after anesthesia were compared between the two groups. Results The MAP and HR levels of T1,T2 and T3 in the observation group were lower than those in the control group,and the difference was statistically significant（P〈0.05）. The time of respiratory recovery,eyes opening and time of extubation were shorter than those in the control group,and the difference was statistically significant（P〈0.05）. Conclusion The effect of remifentanyl combined propofol in anesthesia of children with adenoidectomy and tonsillectomy is obvious. It can stabilize the hemodynamics of children body,fasten their waking up and smooth their breathing.