异丙酚联合瑞芬太尼靶控输注在小儿扁桃体切除术的应用

Application of Propofol-Remifentanil given by target-controlled infusion for Child undergoing Tonsillectomy

目的:观察异丙酚联合瑞芬太尼靶控输注在小儿扁桃体切除术的应用效果。方法:60例拟行扁桃体切除术患儿,采用靶控输注异丙酚及瑞芬太尼维持麻醉。观察并记录麻醉前5 min、麻醉后10、30 min及拔管后5 min的血压(SBP)和心率(HR)的变化,以及苏醒时间、苏醒期呼吸抑制、喉痉挛、呕吐、躁动等不良反应。结果:麻醉后10 min及30min血压及心率与诱导前相比虽然有明显下降,但均在正常值范围内。所有患儿均在术毕25 min内清醒,均满足拔管指征。平均拔管时间为(18±5)min,23例安全拔除气管,2例重症阻塞性睡眠呼吸暂停低通气综合征患儿拔管后出现呼吸抑制,1例经面罩给氧有效(SpO2>96%),另1例再次行气管插管回病房术后48 h拔管。结论:异丙酚联合瑞芬太尼靶控输注能安全有效地应用于小儿扁桃体切除术。

Objective:To investigate the application of propofol and remifentanil given by target-controlled infusion for child undergoing tonsillectomy.Methods:60 children undergoing tonsillectomy receiving anesthesia with propofol and remifentanil given by target-controlled infusion.Blood pressure and heart rate 5 min before and 10 min,30 min after anesthesia was recorded,adverse effect such as analeptic time,respiratory depression,hyperkinesis larynges,vomiting,and restlessness were observed.Results:Compared with that before anesthesia,blood pressure and heart rate 10 min,30 min after anesthesia decreased markedly,but those were in the range of normal values.All children came to be conscious 25 min after operation.The average extubation time was(18±5) min.23 cases were extubated safely,respiratory depression emerged in 2 cases with severe obstructive sleep apnea,one case SpO2 exceeded 96% when receiving oxygen,and other case need to intubation one more time.Conclusion:The application of propofol remifentanil given by target-controlled infusion for Child undergoing Tonsillectomy is recommendable.