瑞芬太尼与尼卡地平用于婴幼儿唇腭裂修复术控制性降压的效果比较  

Controlled Hypotension during Cheiloplasty or Palatorrhaphy in Young Children:A Comparison between Remifentanil and Nicardipine

作　　者：张铁军[1] 陈焰[1] 刘可斌[1] 

机构地区：[1]武汉大学口腔医学院麻醉科,湖北武汉430079

出　　处：《口腔医学研究》2011年第7期621-623,627,共4页Journal of Oral Science Research

摘　　要：目的:比较瑞芬太尼与尼卡地平用于婴幼儿唇腭裂修复术控制性降压的效果。方法:选择择期行唇腭裂修复术患儿48例,随机分为两组。R组泵注瑞芬太尼控制性降压,N组泵注尼卡地平控制性降压。观察并记录各组患儿诱导前、降压前、降压后2、5、10、30min、停药后1、3、5、10min的血压(MAP)、心率(HR),观察并记录各组患儿手术野Fromme’s评分、术中出血量(EBL)及麻醉恢复时间,分别于术前、术中、术后抽取足背动脉血检测血糖(Glu)、乳酸(Lac)含量。结果:两组患儿在降压开始2分钟后的MAP都降到了50～60mmHg,但R组患儿MAP在停止降压后恢复要早于N组。R组患儿降压后5、10、30min的HR与麻醉前及降压前相比,显著降低(P<0.05),而N组患儿降压后2、5、10、30min及停止降压后1、3min的HR与麻醉前、降压前以及与R组相比均显著升高(P<0.05)。两组患儿手术野Fromme’s评分、EBL、麻醉恢复时间以及各时点Glu、Lac含量差异均无显著性。结论:瑞芬太尼控制性降压效果满意,相对于尼卡地平可控性更强,无心率反射性增快的副作用。Objective： To compare the effect of Remifentanil and Nicardipine on controlled hypotension during chel- loplasty or palatorrhaphy in young children. Methods： 48 young children undergoing elective cheiloplasty or palator- rhaphy were randomly and evenly divided into two groups： group R and group N. Remifentanil was continuously in- fused in group R yet Nicardipine was continuously infused in group N for controlled hypotension during the opera- tion. Mean arterial pressure（MAP） and heart rate（HR） were recorded at the following time points： before induc- tion, immediately before commencing controlled hypotension, 2,5,10,30 minutes after controlled hypotension, and 1,3,5,10 minutes after the end of controlied hypotension. Fro mme＇ s scale of surgical field, estimated blood loss （EBL） and recovery time were also recorded. Concentration of glucose（Glu） and lactic acid（Lac） of blood drawed from radial artery were detected before, during and after operation. Results： MAP in two groups were both de- creased to 50--60mmHg 2 minutes after controlled hypotension, but recovery of MAP in group R was faster than group N after the end of controlled hypotension. HR was significantly lower at 5,10,30 minutes after controlled hy- potension than that before induction and immediately before commencing controlled hypotension in group R（P^0. 05）, but HR was significantly higher at 2,5,10,30 minutes after controlled hypotension, and at 1,3 minutes after the end of controlled hypotension than that before induction and immediatel before commencing controiled hypoten- sion in grouP N（P^0.05）. There were no significantly difference between group R and group N in Promme^s scale of surgical ＇field, EBL, and concentration of Glu and Lac of blood at any points. Conclusion： Remifentanil for con- trolled hyp0tension in this study is very effective, and its controllability is better than Nicardipine. It has no side effect like Nicardipine that can cause heart rate increase, so it is safe for controlled h

关 键 词：控制性降压瑞芬太尼忘卡地平 唇裂修复术腭裂修复术 

分 类 号：R726.1[医药卫生—儿科]