阿芬太尼和舒芬太尼用于患儿腹腔镜疝囊高位结扎术的效果比较  

Comparison of effect of alfentanil versus sufentanil in high ligation of laparoscopic hernia sac in children

作　　者：龙翔 查宁晖 曾萍[1] 龚园[1] LONG Xiang;ZHA Ninghui;ZENG Ping;GONG Yuan(Department of Anesthesiology,Institute of Anesthesia and Critical Care Medicine,China Three Gorges University,the First College of Clinical Medical Science,China Three Gorges University&Yichang Central People s Hospital,Yichang 443003,China)

机构地区：[1]三峡大学麻醉与急危重症医学研究所,三峡大学第一临床医学院,宜昌市中心人民医院麻醉科,湖北省宜昌市443003

出　　处：《临床麻醉学杂志》2021年第12期1263-1266,共4页Journal of Clinical Anesthesiology

摘　　要：目的比较阿芬太尼和舒芬太尼用于患儿腹腔镜疝囊高位结扎术的安全性和有效性。方法选择2020年12月至2021年1月全麻下择期行腹腔镜下疝囊高位结扎术患儿38例,男31例,女7例,月龄12~72个月,ASAⅠ级。随机分为两组:舒芬太尼组(SF组,n=19)和阿芬太尼组(AF组,n=19)。AF组采用阿芬太尼10μg/kg诱导,术中持续泵注阿芬太尼0.8μg·kg^(-1)·min^(-1)维持麻醉;SF组采用舒芬太尼0.3μg/kg诱导,术中持续泵注0.9%生理盐水。两组肌松药物和七氟醚用量相同。记录麻醉诱导前、麻醉诱导后1 min、气管插管即刻、切皮时、气腹建立时的HR和MAP;记录拔管时间、苏醒时间;记录在PACU苏醒期FLACC疼痛评分等级;记录入PACU时、入PACU后30 min、出PACU即刻Ramsay镇静评分。结果与SF组比较,AF组苏醒时间明显缩短(P<0.05)。两组不同时点HR、MAP、拔管时间、PACU苏醒期FLACC疼痛评分等级和不同时点Ramsay镇静评分差异无统计学意义。结论阿芬太尼和舒芬太尼均可安全有效应用于患儿腹腔镜下疝囊高位结扎术麻醉诱导与维持,血流动力学波动小。阿芬太尼10μg/kg诱导时患儿苏醒时间短。Objective To compare the safety and efficacy of alfentanil and sufentanil in laparoscopic high ligation of hernia sac in children.Methods Thirty-eight children undergoing laparoscopic hernia sac high ligation under general anesthesia were selected from December 2020 to January 2021,31 males and 7 females,aged 12-72 months,ASA physical statusⅠ,were randomly divided into two groups:sufentanil group(group SF,n=19)and alfentanil group(group AF,n=19).The group AF were induced with alfentanil at 10μg/kg and maintained anesthesia with alfentanil at 0.8μg·kg^(-1)·min^(-1).Group SF was induced at sufentanil 0.3μg/kg,0.9%normal saline was pumped continuously during the operation,and the dosage of muscle relaxant and sevoflurane remained unchanged.HR and MAP were recorded before anesthesia induction,1 minute after anesthesia induction,immediately after endotracheal intubation,incision,pneumoperitoneum establishment,respectively.The extubation time and recovery time were recorded.The highest behavioral Face,Legs,Activity,Crying,Consolability(FLACC)score during PACU recovery was recorded,and Ramsay sedation score at PACU induction,30 minutes,and discharge from PACU was recorded.Results Compared with group SF,group AF had significantly shorter recovery time(P<0.05).There were no statistical significance in HR,MAP,extubation time,the distribution of FLACC pain score during awakening period and Ramsay sedation score between the two groups.Conclusion Alfentanil and sufentanil can be used safely and effectively for inducing and maintaining anesthesia during laparoscopic high ligation of hernia sac in children,HR and MAP fluctuations are mild,and waking time is short when using 10μg/kg alfentanil induction.

关 键 词：阿芬太尼 儿童 腹股沟斜疝 镇痛 

分 类 号：R726.1[医药卫生—儿科]