地氟烷联合瑞芬太尼在腹腔镜小儿肾盂成形术中的应用效果

Effect of Desflurane Combined with Remifentanil in Laparoscopic Pyeloplasty in Children

目的:观察地氟烷联合瑞芬太尼在腹腔镜小儿肾盂成形术中的应用效果。方法:选取福州儿童医院2017年6月-2021年6月收治的92例腹腔镜小儿肾盂成形术患儿,按照随机数字表法将其分为A组与B组,各46例。两组均应用舒芬太尼0.2~0.3μg/kg、丙泊酚3~4 mg/kg、罗库溴铵0.4~0.6 mg/kg进行麻醉诱导。A组予以瑞芬太尼0.1~0.2μg/(kg·min)、七氟烷浓度2%~3%进行麻醉维持,B组予以瑞芬太尼0.1~0.2μg/(kg·min)、地氟烷浓度5%~7%进行麻醉维持。比较两组术中不同时刻的血流动力学指标、苏醒时间以及不良反应发生情况。结果:B组手术即刻、术毕时、清醒时的平均动脉压(79.14±7.39)、(77.11±7.34)、(72.01±7.23)mmHg与心率(121.92±11.90)、(120.22±9.25)、(115.37±8.99)次/min均低于A组(87.12±6.38)、(84.65±6.73)、(80.90±6.45)mmHg,(130.36±12.68)、(129.54±10.90)、(121.76±10.34)次/min(P<0.05);B组呼吸恢复、睁眼、拔管的时间(1.94±0.66)、(4.61±1.89)、(5.92±1.03)min均短于A组(2.52±0.78)、(7.34±2.76)、(9.76±1.45)min(P<0.05)。B组的不良反应发生率为17.39%低于A组的36.96%(P<0.05)。结论:地氟烷联合瑞芬太尼应用于腹腔镜小儿肾盂成形术中的效果较好,可稳定患儿术中血流动力学指标,且术后苏醒快,不良反应少,值得应用。

Objective:To observe the effect of Desflurane combined with Remifentanil in laparoscopic pyeloplasty in children.Method:A total of 92 children underwent laparoscopic pyeloplasty in Fuzhou children’s Hospital from June 2017 to June 2021 were selected.They were divided into group A and group B according to random number table method,with 46 cases in each group.Both groups were treated with Sufentanil 0.2-0.3μg/kg,Propofol 3-4 mg/kg,Rocuronium 0.4-0.6 mg/kg for anesthesia induction.Group A was given Remifentanil 0.1-0.2μg/(kg·min)and Sevoflurane concentration of 2%-3% were used for anesthesia maintenance.Group B was given Remifentanil 0.1-0.2μg/(kg·min)and Desflurane concentration of 5%-7% were used for anesthesia maintenance.The hemodynamic indexes at different times,recovery time and adverse reactions were compared between the two groups.Result:The mean arterial pressure(79.14±7.39),(77.11±7.34),(72.01±7.23)mmHg and heart rate(121.92±11.90),(120.22±9.25),(115.37±8.99)times/min in group B were all lower than those in group A(87.12±6.38),(84.65±6.73),(80.90±6.45)mmHg,(130.36±12.68),(129.54±10.90),(121.76±10.34)times/min(P<0.05).The time of respiratory recovery,eye opening and extubation in group B(1.94±0.66),(4.61±1.89),(5.92±1.03)min were shorter than those in group A(2.52±0.78),(7.34±2.76),(9.76±1.45)min(P<0.05).The incidence of adverse reactions in group B was 17.39% lower than 36.96% in group A(P<0.05).Conclusion:The effect of Desflurane combined with Remifentanil in laparoscopic pyeloplasty in children is good.It can stabilize the intraoperative hemodynamic indexes,wake up quickly and have less adverse reactions.It is worthy of application.