七氟醚复合瑞芬太尼加小剂量氟比洛芬酯对婴幼儿麻醉的临床效果  

Clinical observation of sevoflurane coupled with remifentanil plus low-dose flurbiprofen axetil on the effect of anesthesia in pediatric patients

作　　者：徐文[1] 毛树印 胡胜[3] Xu Wen;Mao Shuyin;Hu Sheng(Department of Anesthesiology,No.413 Hospital of CPIA,Zhoushan 316000,China)

机构地区：[1]解放军第四一三医院麻醉科 [2]解放军65535部队医院 [3]第四军医大学西京医院

出　　处：《海军医学杂志》2018年第5期417-419,423,共4页Journal of Navy Medicine

摘　　要：目的探讨七氟醚复合瑞芬太尼加氟比洛芬酯在婴幼儿手术全身麻醉的安全性和有效性。方法选择2014年9月至2016年3月在解放军第四一三医院确诊为ASAⅠ～Ⅱ级,择期行气管插管全身麻醉的8个月～3岁婴幼儿60例,随机分为氯胺酮组(K组)、瑞芬太尼+七氟醚组(RS组)、瑞芬太尼+七氟醚+氟比洛芬酯组(RSF组),每组20例。K组行氯胺酮静脉麻醉,RS组和RSF组术中麻醉维持以七氟醚复合瑞芬太尼为主,RSF组在手术开始前和手术结束后各静脉注射1次氟比洛芬酯0. 5 mg/kg。记录3组患儿入室时(T1)、诱导后(T2)、手术开始后30 min(T3)、拔出气管插管时(T4)患儿的心率(HR)、平均血压(MAP)的变化、术后自主呼吸恢复时间和苏醒时间及术后躁动发生率。结果 K组患儿各时间点HR、MAP明显高于RS组、RSF组(P <0. 05),RS组与RSF组之间差异无统计学意义(P> 0. 05); K组苏醒时间及拔管时间明显长于RS组和RSF组,RS组与RSF组之间差异无统计学意义(P> 0. 05)。术后躁动发生率RSF组明显低于K组和RS组,差异有统计学意义(P <0. 05)。结论七氟醚复合瑞芬太尼加小剂量氟比洛芬酯苏醒迅速,血液动力学稳定,苏醒期躁动发生率低,适合于婴幼儿的手术麻醉。Objective To investigate the safety and efficacy of general anesthesia with sevoflurane and remifentanil plus low- dose flurbiprofen axetil in infants and children. Methods In accordance with ASA I - lI , a total of 60 pediatric patients with an age from 8 months to 3 years underwent general anesthesia, and were randomly divided into 3 groups： the K group （the ketamine anesthesia group ）, the RS group （the remifentanil ＋ sevoflurane anesthesia group） and the RSF group （the remifentanil ＋ sevoflurane ＋ flurbi- profen axetil anesthesia group）, each consisting of 20 patients. The K group had ketamine intravenous anesthesia, while the anesthesia of the RS and RSF groups was maintained mainly with sevoflurane combined with remifentanil during surgery, and the RSF group was supplemented with an additional injection of 0.5 mg/kg flurbiprofen axetil both before surgery and after termination of surgery. Changes in heart rate （HR）, mean arterial pressure （MAP）, recovery time of postoperative spontaneous respiration, conscious recovery time and incidence of postoperative restlessness as well were recorded at the following 4 time points： before entry into the surgical suite （ T1 ）, induction of anesthesia （ T2 ）, 30 min after beginning of surgery （ T3 ） and extubation of air pipe （ T4 ）. Results The values of HR and MAP in the K group were significantly higher than those in the RS and RSF groups, with statistical significance （ P 〈 0.05 ） , however, no statistical significance could be noted, when comparisons were made between the RS and RSF groups （P 〉 0.05 ）. The conscious recovery time and air pipe extubation time in the K group were obviously longer than that of the RS and RSF groups, however there was no statistical significance, when comparisons were made between the RS and RSF groups（P 〈 0.05 ）. Nevertheless, the inci-dence of postoperative restlessness in the RSF group was significantly lower than that in the K group and RS group （ P 〈 0.05 ）. Conc

关 键 词：婴幼儿手术 七氟醚 瑞芬太尼 氟比洛芬酯 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]