瑞芬太尼复合丙泊酚全凭静脉麻醉在小儿斜视手术麻醉中的应用

Application of Total Intravenous Anesthesia with Remifentanil and Propofol in Anesthesia for Pediatric Strabismus Surgery

目的:探讨瑞芬太尼复合丙泊酚全凭静脉麻醉在小儿斜视手术麻醉中的应用。方法:选取2017年12月-2019年12月本院行小儿斜视手术的90例患儿,根据简单随机法分为观察组和对照组,每组45例,两组麻醉诱导均采用阿托品、氯胺酮、咪达唑仑,其中对照组给予丙泊酚与氯胺酮维持麻醉,观察组给予瑞芬太尼复合丙泊酚麻醉维持。观察两组血流动力学指标,并记录两组麻醉苏醒时间、呼吸恢复时间、拔管时间、住院时长及不良反应发生情况。结果:两组麻醉前平均动脉压及心率比较差异无统计学意义(P>0.05),气管插管后及3 min后均低于麻醉前(P<0.05),且观察组波动幅度小于对照组(P<0.05);观察组呼吸恢复时间、麻醉苏醒时间、拔管时间、住院时长均短于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:瑞芬太尼复合丙泊酚全凭静脉麻醉应用于小儿斜视手术麻醉中,相比于常规静吸复合麻醉,其效果更好,不仅能能稳定血压及心率,而且安全可靠,对于患者尽早苏醒具有显著作用。

Objective:To investigate the application of total intravenous anesthesia with Remifentanil and Propofol in anesthesia for pediatric strabismus surgery.Method:Ninety children undergoing pediatric strabismus surgery in the hospital were selected between December 2017 and December 2019,and divided into observation group and control group according to simple randomization method,with 45 cases in each group.Both groups were given anesthesia induction with Atropine,Ketamine,and Midazolam.The control group was given Propofol and Ketamine to maintain anesthesia,while the observation group was given Remifentanil and Propofol to maintain anesthesia.Hemodynamic indexes in the two groups were observed.The anesthesia recovery time,breathing recovery time,extubation time,hospitalization time and adverse reactions in the two groups were recorded.Result:Before anesthesia,there was no statistically significant difference in mean arterial pressure and heart rate between the two groups(P>0.05).The two indicators were lower after tracheal intubation and at 3 min after tracheal intubation than before anesthesia(P<0.05).Meanwhile,the fluctuation range in observation group was smaller than that in the control group(P<0.05).The breathing recovery time,anesthesia recovery time,extubation time and hospitalization time of observation group were shorter than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with conventional intravenous-inhalation combined anesthesia,total intravenous anesthesia with Remifentanil and Propofol can achieve better anesthetic effect in pediatric strabismus surgery,which not only can stabilize blood pressure and heart rate,but also is safe and reliable,which is of great significance for early recovery of patients.