丙泊酚-瑞芬太尼复合七氟醚吸入对小儿腹腔镜疝囊高位结扎术的麻醉效果及安全性探讨

Efficacy and safety of propofol-Remifentanil combined with sevoflurane inhalation anesthesia for high ligation of laparoscopic hernia sac in children

目的研究丙泊酚-瑞芬太尼复合七氟醚吸入在小儿腹腔镜疝囊高位结扎手术中的麻醉效果以及安全性。方法选取2017年7月至2020年10月于淮安市第一人民医院行腹腔镜疝囊高位结扎手术的小儿患者100例,抽签将100例患儿分为复合吸入组与对照组,每组各50例。对照组行丙泊酚-瑞芬太尼全凭静脉麻醉,复合吸入组行丙泊酚-瑞芬太尼复合七氟醚吸入全身麻醉。对比2组患儿术前、术中1 h、术中2 h、术后1 h、术后2 h的血压、心率等血流动力学指标、患儿清醒时间、术后视觉模拟评分法(VAS)评分、拔管时间以及不良反应发生率情况。结果 2组患儿术前血压及心率情况比较,差异无统计学意义(P>0.05);复合吸入组患儿术后1 h、术后2 h的血压、心率等血流动力学指标一直稳定处于安全范围内,且明显小于对照组患儿,差异均有统计学意义(P<0.05);复合吸入组患儿清醒时间、拔管时间、术后VAS评分以及不良反应发生率明显低于对照组患儿,差异均有统计学意义(P<0.05)。结论丙泊酚-瑞芬太尼复合七氟醚吸入在小儿腹腔镜疝囊高位结扎手术中的麻醉效果更好,具有更高的安全性。

Objective To study the anesthetic effect and safety of propofol-Remifentanil combined with sevoflurane inhalation general anesthesia in laparoscopic high ligation of hernia sac in children.Methods Total of 100 pediatric patients who underwent laparoscopic high ligation of hernia sac in Huai'an First People's Hospital from July 2017 to October 2020 were selected.100 pediatric patients were divided into compound inhalation group and control group by lottery,with 50 patients in each group.The control group received propofol-Remifentanil inhalation general anesthesia,and the compound inhalation group received propofol-Remifentanil combined with sevoflurane inhalation general anesthesia.Blood pressure,heart rate and other hemodynamic indicators,awake time,VAS score,extubation time and adverse reaction rate of the children in the two groups were compared preoperative,1 hour and 2 hours during operation,1 hour and 2 hours after surgery.Results The preoperative blood pressure and heart rate between two groups were not statistically significant(P>0.05).The blood pressure,heart rate and other hemodynamic indicators between two groups during 1 hour and 2 hours after surgery were statistically significant(P<0.05).The awake time,postoperative VAS score,adverse reaction rate and extubation time of children in the compound inhalation group were significantly lower than those in the control group(P<0.05).Conclusion Propofol-Remifentanil combined with sevoflurane inhalation general anesthesia is effective and safe in laparoscopic high ligation of hernia sac in children.