瑞芬太尼丙泊酚全凭静脉麻醉于小儿眼科手术的临床疗效观察  

Effect of Total Intravenous Anesthesia with Remifentanil-Propofol on Ophthalmologie Operation of Children

作　　者：何卓文[1] 刘东辉[1] 欧阳文博[1] 李伟彬[1] 田丰[1] 张坤全[1] 

机构地区：[1]肇庆市第一人民医院麻醉科,526020

出　　处：《国际医药卫生导报》2010年第8期962-965,共4页International Medicine and Health Guidance News

摘　　要：目的介绍瑞芬太尼复合丙泊酚麻醉在小儿眼科手术中的优点。方法选择ASAⅠ～Ⅱ级、年龄2～13岁、择期行眼部手术的小儿50例，随机分为观察组和对照组。观察组瑞芬太尼、丙泊酚诱导和维持；对照组芬太尼、丙泊酚诱导，丙泊酚和异氟醚维持。观察两组病例围麻醉期血流动力学变化及气管拔管时间、苏醒时间，观察患儿拔管后呼吸困难、苏醒期躁动、术后恶心呕吐的发生率。结果两组患儿的SBP、DBP、HR在插管后1min、手术开始、拔管时、术中最高平均值、清醒时各时间点均有明显差异（P〈0．05或P〈0．01）。观察组围麻醉期的血流动力学较对照组平稳，停药至气管拔管时间及苏醒时间较对照组明显缩短（P〈0．05），术后苏醒躁动的发生率较对照组明显减少（P〈0．05）。结论瑞芬太尼复合丙泊酚全凭静脉麻醉是一种起效迅速、术中平稳、苏醒快速平顺，值得在小儿眼科手术中推广使用的麻醉方法。Objective To introduce the advantages of remifentanil-propofol anaesthesia in ophthahnologic operation of children. Method A total of 50 cases of children with Ⅰ to Ⅱ degrees of ASA were randomly divided into two groups, i.e. the observation group and control group. These children, aged from 2 to 13 years, were prepared to be operated with selective ophthalmologic operation. The observation group was induced and maintained with remifentanil-propofol, while the control group was induced with remifentanil-propofol and maintained with propofol-isoflurane. The hemodynamics changes, extubation time and analepsia time of the two groups during anesthesia period were observed; moreover, after extubation, the incidence rates of dyspnea, restlessness during analepsia period, nausea and vomiting after operation were also observed. Result The values of SBP, DBP and HR of the groups at lmin after intubation, the beginning of the surgery, extubation period, surgery period and regaining consciousness period were significantly different （P〈0.05 or P〈0.01）. The hemodynamics of observation group during anesthesia period was more stable than that of control group; the time from withdrawal to extubation and analepsia of observation group was obviously shorter than that of control group（ P〈0.05 ）; after operation, the incidence rate of restlessness of observation group was less than that of control group （ P〈 0.05 ）. Conclusion Total intravenous anesthesia with remifentanil-propofol is a kind of anesthesia method with quick effect, good stability during operation, and quick and smooth recovery of the patients. Therefore, this anaesthesia method is deserved to be recommended in the ophthalmolngic operation of children.

关 键 词：小儿 眼科手术 瑞芬太尼 丙泊酚 

分 类 号：R726[医药卫生—儿科]