瑞芬太尼联合七氟烷维持麻醉在小儿腹股沟疝手术中的应用效果

Application effects of Remifentanil combined with Sevoflurane for anesthesia maintenance in children undergoing inguinal hernia surgeries

目的:观察瑞芬太尼联合七氟烷维持麻醉在小儿腹股沟疝手术中的应用效果。方法:选取94例腹股沟疝患儿为研究对象,按照随机数字表法分为对照组和观察组各47例。两组均行腹股沟疝手术治疗,对照组予以七氟烷维持麻醉,观察组予以瑞芬太尼联合七氟烷维持麻醉。比较两组麻醉时间相关指标(自主呼吸恢复时间、苏醒时间、拔管时间、定向力恢复时间)、术后不同时间[麻醉诱导前(T_(0))、插管时(T_(1))、切皮时(T_(2))、术毕(T_(3))、拔管时(T_(4))、拔管后5 min(T_(5))]血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO_(2))]水平、躁动评分和不良反应发生率。结果:观察组自主呼吸恢复时间、苏醒时间、拔管时间、定向力恢复时间均短于对照组,差异有统计学意义(P<0.05);T_(2)~T_(5)时段,观察组MAP水平均高于对照组,差异有统计学意义(P<0.05);T_(4)、T_(5)时,观察组HR水平均低于对照组,差异有统计学意义(P<0.05);T_(3)~T_(5)时段,观察组SPO_(2)水平均高于对照组,差异有统计学意义(P<0.05);苏醒时、拔管后5 min、送恢复室后10 min,观察组躁动评分均低于对照组,差异有统计学意义(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:瑞芬太尼联合七氟烷维持麻醉应用于小儿腹股沟疝手术中可改善麻醉时间相关指标水平和血流动力学指标水平,以及降低躁动评分,优于单纯七氟烷维持麻醉效果。

Objective:To observe application effects of Remifentanil combined with Sevoflurane for anesthesia maintenance in children undergoing inguinal hernia surgeries.Methods:94 children with inguinal hernia were selected as the research objects and were divided into control group and observation group according to the random number table method,47 cases in each group.Both groups underwent inguinal hernia surgeries.The control group received Sevoflurane for anesthesia maintenance,while the observation group was given Remifentanil combined with Sevoflurane for anesthesia maintenance.The levels of anesthesia time-related indicators(spontaneous breathing recovery time,awaking time,extubation time,orientation recovery time),the hemodynamic indicator levels[heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO_(2))],were measured at different postoperative times[before anesthesia induction(T_(0)),during intubation(T_(1)),during skin resection(T_(2)),after surgery(T_(3)),during extubation(T_(4)),5 min after extubation(T_(5))]the restlessness score,and the incidence of adverse reactions were compared between the two groups.Results:The spontaneous breathing recovery time,awaking time,extubation time,and orientation recovery time in the observation group were all shorter than those in the control group,and the differences were statistically significant(P<0.05).From T_(2) to T_(5),the MAP level of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).At T_(4) and T_(5),the HR levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).From T_(3) to T_(5),the SPO_(2) level of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).At the time of awakening,5 minutes after extubation,and 10 minutes after being sent to the recovery room,the restlessness scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Remifentanil combined with Sevoflurane for anesthesia maintenance in the children undergoing inguinal hernia surgeries can improve the levels of anesthesia time-related indicators and hemodynamic indicators,and reduce the restlessness score.Moreover,it is superior to single Sevoflurane.