瑞芬太尼分别复合丙泊酚与右美托咪定对全麻保留自主呼吸患儿气道异物取出术镇静效果及安全性  

Sedative effect and safety of remifentanil combined with propofol and dexmedetomidine for removal of airway foreign bodies in children with spontaneous breathing under general anesthesia

作　　者：张玉鸟 翟晓莉 Zhang Yuniao;Zhai Xiaoli(Department of Anesthesiology,Luoyang Maternal and Child Health Hospital,Luoyang,Henan 471000)

机构地区：[1]洛阳市妇幼保健院,河南洛阳471000

出　　处：《辽宁医学杂志》2021年第1期10-12,共3页Medical Journal of Liaoning

摘　　要：目的探究瑞芬太尼分别复合丙泊酚与右美托咪定对全麻保留自主呼吸患儿气道异物取出术镇静效果及安全性。方法选取2019年1月-2020年5月期间收入我院治疗的86例气道异物患儿为研究对象,根据患儿入院的先后顺序分为对照组与观察组各43例。对照组实施瑞芬太尼复合丙泊酚麻醉,观察组实施瑞芬太尼复合右美托咪定麻醉,分别记录患儿进入手术室时(T0)、麻醉诱导呼吸平稳时(T1)、支气管镜置入气管时(T2)、退镜时(T3)各时间点患者的心率(HR)、呼吸频率(RR)以及血氧饱和度(SPO2),并记录围手术期不良事件的发生情况。结果与患儿进入手术室时(T0)相比,两组患儿在麻醉诱导T1时刻后,HR、RR均下降(P<0.05),术中观察组RR、SPO2高于对照组(P<0.05);且观察组体动、支气管痉挛、呛咳、血氧饱和度下降总发生率低于对照组(P<0.05)。结论在全麻保留自主呼吸中,与瑞芬太尼复合丙泊酚麻醉方式相比较,瑞芬太尼复合右美托咪定复合麻醉可更有效的维持患儿气道异物取出术中的血液动力学稳定,降低不良事件发生风险,安全性更高,值得临床推广。Objective To explore the sedative effect and safety of remifentanil combined with propofol and dexmedetomidine in the removal of airway foreign bodies in children with spontaneous breathing under general anesthesia.Methods A total of 86 children with airway foreign bodies admitted to our hospital from January 2019 to May 2020 were selected as study subjects,and were divided into control group and observation group,respectively,with 43 cases according to the order of admission.Control the implementation of compound fentanyl propofol anesthesia,observation group implementation of fentanyl compound right beautiful mi on anesthesia,record the children into the operating room(T0),smooth anesthesia induction of breathing(T1),the bronchoscope into the trachea(T2),mirror(T3)each time the patient’s heart rate(HR),respiratory frequency(RR)and blood oxygen saturation(SPO2),and recording the occurrence of perioperative adverse events.Results Compared with the time when the children entered the operating room(T0),HR and RR in both groups decreased after T1 induction of anesthesia(P<0.05),while RR and SPO2 in the intraoperative observation group were higher than those in the control group(P<0.05).The total incidence of somatospasm,bronchospasm,cough and hypoxia in the observation group was lower than that in the control group(P<0.05).Conclusion Compared with the anesthesia method of remifentanil combined with propofol,remifentanil combined with dexmedetomidine can more effectively maintain the hemodynamic stability during the removal of airway foreign body in children,reduce the risk of adverse events,and improve the safety.Therefore,it is worthy of clinical promotion.

关 键 词：瑞芬太尼 丙泊酚 右美托咪 保留自主呼吸 患儿 气道异物 

分 类 号：R726.1[医药卫生—儿科]