瑞芬太尼结合七氟烷复合麻醉方法对小儿全麻苏醒期躁动的影响

Effect of Remifentanil combined with Sevoflurane anesthesia on restlessness during recovery period in general anesthesia in children

目的分析瑞芬太尼结合七氟烷复合麻醉方法对小儿全身麻醉(全麻)苏醒期躁动的影响。方法 98例行全麻手术治疗的患儿,按麻醉方式不同分为对照组和观察组,各49例。对照组行七氟烷吸入麻醉,观察组行瑞芬太尼+七氟烷复合麻醉,比较两组患者不同时刻血流动力学指标及麻醉相关时间指标、苏醒期躁动发生情况、不良反应发生情况。结果两组患者麻醉诱导结束(T1)、气管插管(T2)、气管拔除(T3)时的心率(HR)、收缩压(SBP)、舒张压(DBP)及平均动脉压(MAP)水平均显著低于手术即刻(T0)、返回手术室(T4)时,差异具有统计学意义(P<0.05);观察组T1、T2、T3时的HR、SBP、DBP及MAP水平均低于对照组同时刻,差异具有统计学意义(P<0.05)。观察组患者的麻醉诱导时间(3.89±0.52)min、恢复呼吸时间(5.26±0.82)min、苏醒时间(8.56±0.71)min及拔管时间(8.33±0.26)min均短于对照组的(5.03±0.47)、(6.59±0.92)、(10.23±0.62)、(9.88±0.54)min,差异具有统计学意义(P<0.05)。观察组患者的苏醒期躁动发生率8.16%(4/49)低于对照组的32.65%(16/49),且躁动分级0级占比91.84%(45/49)高于对照组的67.35%(33/49),差异具有统计学意义(P<0.05)。观察组患者的不良反应发生率为16.33%(8/49),低于对照组的46.94%(23/49),差异具有统计学意义(P<0.05)。结论瑞芬太尼与七氟烷复合麻醉效果显著,有助于稳定患儿术中血流动力学,加快麻醉苏醒,减少苏醒期躁动,且能降低麻醉不良反应发生率。

Objective To analyze the effect of remifentanil combined with sevoflurane anesthesia on restlessness during recovery period in general anesthesia in children.Methods A total of 98 children undergoing general anesthesia were divided by different anesthesia methods into control group and observation group,with 49 cases in each group.The control group received sevoflurane inhalation anesthesia,and the observation group received remifentanil+sevoflurane anesthesia.Comparison were made on hemodynamic parameters and anesthesia-related time indicators,the occurrence of restless during the recovery period,and occurrence of adverse reactions were compared between the two groups at different times.Results Both groups had significantly lower heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)levels at induction of anesthesia(T1),endotracheal intubation(T2),tracheal extraction(T3)than at surgery immediately(T0),return to the operating room(T4),and their differences were statistically significant.(P<0.05).The observation group had lower HR,SBP,DBP and MAP levels at T1,T2 and T3 than the control group,and the difference was statistically significant(P<0.05).The observation group had anesthesia induction time as(3.89±0.52)min,recovery time as(5.26±0.82)min,recovery time as(8.56±0.71)min and extubation time(8.33±0.26)min than(5.03±0.47),(6.59±0.92),(10.23±0.62),(9.88±0.54)min in the control group,and their difference was statistically significant(P<0.05).The observation group had lower incidence of restless during recovery period as 8.16%(4/49)than 32.65%(16/49)in the control group,and higher proportion of restless grading 0 as 91.84%(45/49)than 67.35%(33/49)in the control group,and the differences were statistically significant(P<0.05).The observation group had lower incidence of adverse reactions as 16.33%(8/49)than 46.94%(23/49)in the control group,and the difference was statistically significant(P<0.05).Conclusion The combined anesthesia of Remifentanil and Sevoflurane shows remarkable effect,and it can help stabilize the intraoperative hemodynamics,accelerate the recovery of anesthesia,reduce the agitation during the recovery period,and reduce the incidence of anesthetic adverse reactions.