瑞芬太尼、异丙酚全凭静脉麻醉用于小儿扁桃体、腺样体切除手术中的临床观察  

Effects of remifentanil and propofol total intravenous anesthesia on pediatric adenotonsillectomy

作　　者：宋斌[1] 陈月芝[1] 郭芹[1] 

机构地区：[1]石河子人民医院麻醉科,新疆石河子832000

出　　处：《新疆医科大学学报》2009年第8期1170-1172,共3页Journal of Xinjiang Medical University

摘　　要：目的:观察瑞芬太尼、异丙酚全凭静脉麻醉对小儿患者麻醉诱导气管插管及血流动力学的影响,且观察术后苏醒特点。方法:小儿择期扁桃体、腺样体切除手术患者(5～10岁)40例(ASA分级均为Ⅰ级),随机分为R组(患者行瑞芬太尼合用异丙酚全凭静脉麻醉),F组(患者行芬太尼合用异丙酚全凭静脉麻醉),每组20例。于术前5 min(T1)、麻醉诱导气管插管后(T2)、手术切除扁桃体、腺样体时(T3)、手术结束拿出开口器后(T4)观察2组患者血压、心率、血氧饱和度(SpO_2)变化。并对比观察了2组停药至苏醒时间及苏醒情况。结果:R组T2、T3点血压与T1点比较降低(P<0.05),心率T2、T3与T1比较也降低(P<0.05)。F组T3与T1比较血压略有升高(P<0.05),T3、T4点与T1比较心率略有升高(P<0.05)。R组麻醉苏醒时间为(5.6±2.3)min,与F组(14.2±5.7)min比较,苏醒时间快且无躁动、苏醒质量高,但R组苏醒后疼痛明显。结论:瑞芬太尼,异丙酚全凭静脉麻醉具有良好的血流动力学定性且苏醒时间短、苏醒质量高,适用于扁桃体、腺样体切除手术等小儿短小手术麻醉。Objective： To investigate the effects of remifentanil and propofol total intravenous anesthesia on tracheal intubation and hemodynamics, and to observe the characteristics of postoperative recovery on pediatric patients undergoing adenotonsillectomy. Methods： 40 pediatric patients （5-10 years old,ASAI） were randomly divided into 2 groups： group R （remifentanil＋propofol total intravenous anesthesia）, group F （fentanyl＋propofol total intravenous anesthesia）, each group included 20 cases. The variation of blood pressure, heart rate, oxygen hemoglobin saturation （SpO2） were observed at four time points： 5 minutes before operation （T1） ,just after tracheal intubation （T2）, the time when cutting out the gland （T3） and just after operation （T4）. The duration and the characteristics of postoperative recovery were investigated too. Results： In group R, compared to T1, blood pressures at T2, T3 and heart rates at T2and T3 were decreased （P 〈0.05）. In group F, blood pressures at T3, heart rates at T3 and T4 were higher than T1 （P〈0.05）. The recovery duration in group R was （5.6±2.3） min,which was faster than group F （14.2±5.7） min. There was no fidgetiness during resuscifation time in group R,but the postoperative pain was more obvious. Conclusion： On pediatric patients undergoing adenotonsillectomy, remifentanil and propofol total intravenous anesthesia could efficiently restrain harmful stress. They could also maintain hemodynamic stability, the recovery duration and quality were better too. This kind of anesthesia method was ideal during pediatric adenotonsillectomy.

关 键 词：瑞芬太尼 异丙酚 全凭静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]