小儿静脉麻醉中的瑞芬太尼-氯胺酮应用安全性分析

Safety Analysis of Remifentanil Ketamine in Pediatric Intravenous Anesthesia

目的分析瑞芬太尼-氯胺酮在小儿静脉麻醉中的应用安全性。方法在该院2016年1—9月接收的小儿静脉麻醉患者中随机选取100例,依照麻醉方式将其分成2组,其中分别为瑞芬太尼-氯胺酮组和丙泊酚-氯胺酮组,每组50例,对比两组患儿的的血流动力学、麻醉药用量、苏醒时间、生活质量。结果和丙泊酚-氯胺酮组患儿术中HR(134.1±15.0)次/min相比,瑞芬太尼-氯胺酮组(108.6±9.8)次/min明显偏低;术后麻醉药用量瑞芬太尼-氯胺酮组(55.7±10.3)mg较丙泊酚-氯胺酮组(82.0±10.4)mg明显偏少,苏醒时间瑞芬太尼-氯胺酮组(6.4±1.7)min较丙泊酚-氯胺酮组(15.2±2.0)min明显偏短,差异有统计学意义(P<0.05);和丙泊酚-氯胺酮组相比,瑞芬太尼-氯胺酮组患儿生活质量评分明显偏高,两组持续哭闹情况分别为(7.7±1.0)分和6.1±1.2)分,疼痛感分别为(8.0±1.0)分和(6.4±1.4)分,生理舒适感分别为(6.2±1.0)分和(7.8±1.0)分,差异有统计学意义(P<0.05)。结论瑞芬太尼-氯胺酮在小儿静脉麻醉中的应用,有助于显著提高患儿的生活质量,具有一定安全性,值得推广应用。

Objective This paper tries to analyze the safety and application of remifentanil ketamine in pediatric intravenous anesthesia.Methods 100 cases of children received intravenous anesthesia in this hospital from January to September 2016 were randomly selected and divided into two groups according to different anesthesia methods,the remifentanil ketamine group and propofol ketamine group,with 50 cases in each group,and then the hemodynamics,anesthetic dosage,recovery time,quality of life of the two groups were compared.Results Compared with HR(134.1±15.0)times/min in children with propofol-ketamine group,remifentani-ketamine group was(108.6±9.8)times/min,which was significantly lower.Postoperative anesthetic dosage in fentanyl-ketamine group was(55.7±10.3)mg,compared with propofol ketamine group of(82.0土10.4)mg,significantly fewer,recovery time in the fentanyl-ketamine group was(6.4±1.7)min,shorter than the propofol ketamine group of(15.2±2.0)min,with significant difference(P<0.05);And compared to fentanyl-ketamine group,the quality of life score propofol ketamine group was higher,two groups of continued crying was(7.7±1.0)points and(6.1±1.2)points respectively,the pain was(8.0±1.0)points and(6.4±1.4)points respectively,physical intimacy was(6.2±1.0)points and(7.8±1.0)points respectively,with significant difference(P<0.05).Conclusion The application of remifentanil ketamine in pediatric intravenous anesthesia can significantly improve the quality of life of children with certain security,so it is worthy of popularization and application.