不同剂量盐酸阿芬太尼诱导对小儿支气管镜检查术麻醉效果和苏醒质量的影响  

Effects of Different Doses of Alfentanil Hydrochloride Induction on Anesthesia Effects and Recovery Quality of Children Undergoing Bronchoscopy

作　　者：劳诚毅[1] 林育南[2] 苏烨[1] 黄瑞平[1] Lao Chengyi;Lin Yunan;Su Ye;Huang Ruiping(Nanning Maternal and Child Health Hospital,Nanning 530000,China;The First Affiliated Hospital of Guangxi Medical University,Nanning 530000,China)

机构地区：[1]南宁市妇幼保健院,南宁530000 [2]广西医科大学第一附属医院,南宁530000

出　　处：《儿科药学杂志》2022年第7期39-42,共4页Journal of Pediatric Pharmacy

摘　　要：目的:比较不同剂量盐酸阿芬太尼诱导对小儿支气管镜检查术麻醉效果和苏醒质量的影响,寻找最佳的阿芬太尼诱导剂量。方法:选择1~3岁行小儿支气管镜检查术的喉罩全麻患儿120例,随机分为A、B、C、D四组各30例。A、B、C三组采用盐酸阿芬太尼+顺苯磺酸阿曲库铵注射液0.2 mg/kg+丙泊酚2 mg/kg静脉全麻诱导,A、B、C组的盐酸阿芬太尼诱导剂量分别为30μg/kg、40μg/kg、50μg/kg,术中各组患儿均为丙泊酚2 mg/kg静脉维持麻醉;D组采用常规用量枸橼酸芬太尼2μg/kg+顺苯磺酸阿曲库铵注射液0.2 mg/kg+丙泊酚2 mg/kg静脉全麻诱导。记录四组患儿在麻醉诱导前(T_(0))、插管后(T_(1))、手术开始时(T_(2))与气管拔管时(T_(3))各时间点平均动脉压(MAP)、心率(HR)变化情况;记录四组患儿手术时间、呼吸恢复时间、拔管时间;记录拔管后美国Wisconsin儿童医院的镇静评分表(CHW镇静评分)。结果:四组患儿在T_(0)及T_(3)时间点MAP、HR水平比较差异均无统计学意义(P均>0.05),T_(1)及T_(2)时间点A组MAP、HR水平均高于B、C、D三组(P均<0.05)。A、B两组呼吸恢复时间、拔管时间均优于C组和D组(P<0.05)。四组患儿拔管后的CHW镇静评分组间比较差异有统计学意义,B组拔管后镇静满意度(3~5分)最高(χ^(2)=6.000,P<0.05)。结论:1~3岁小儿支气管镜检查术的喉罩全麻使用盐酸阿芬太尼40μg/kg的静脉诱导剂量有较好的麻醉效果和苏醒质量,值得临床推广。Objective:To compare the effects of different doses of alfentanil hydrochloride induction on anesthesia effects and recovery quality in children undergoing bronchoscopy,so as to find the optimized dose of alfentanil induction.Methods:A total of 120 children aged from 1 to 3 years undergoing pediatric bronchoscopy under laryngeal mask general anesthesia were randomly divided into group A,B,C and D,with 30 cases in each group.Group A,B and C were induced by intravenous general anesthesia induction of alfentanil hydrochloride+atracurium cisbenesulfate injection 0.2 mg/kg+propofol 2 mg/kg.The induction doses of alfentanil hydrochloride in group A,B,and C were respectively 30μg/kg,40μg/kg,and 50μg/kg.Propofol 2 mg/kg was used to maintain anesthesia in each group.Group D was treated with intravenous general anesthesia induction of fentanyl citrate 2μg/kg+atracurium cisbenesulfate injection 0.2 mg/kg+propofol 2 mg/kg.Changes of mean arterial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T_(0)),after intubation(T_(1)),at the beginning of surgery(T_(2))and at the time of extubation(T_(3)).The surgery time,respiratory recovery time and extubation time of four groups were recorded.The sedation score standard of Wisconsin Children’s Hospital in the United States(CHW sedation score)after extubation was recorded.Results:There were no significant differences in MAP and HR levels among four groups at T_(0) and T_(3)(P>0.05),and MAP and HR levels in group A were higher than those in group B,C and D at T_(1) and T_(2)(P<0.05).The respiratory recovery time and extubation time of group A and B were shorter than those of group C and D(P<0.05).There were statistically significant differences in CHW sedation scores among four groups,and group B had the highest sedation satisfaction(from 3 to 5 points)after extubation(χ^(2)=6.000,P<0.05).Conclusion:The intravenous induction dose of 40μg/kg alfentanil hydrochloride for laryngeal mask general anesthesia in 1 to 3-year-old children undergoing bronchoscopy

关 键 词：支气管镜 盐酸阿芬太尼 枸橼酸芬太尼 麻醉效果 苏醒质量 

分 类 号：R726.1[医药卫生—儿科]