瑞芬太尼复合七氟烷喉罩全麻在小儿眼科手术中的应用效果研究  

Study on application effect of remifentanil combined with sevoflurane laryngeal mask general anesthesia in pediatric ophthalmic surgery

作　　者：王双华 田皇华 王庆庆 赵超 WANG Shuang-hua;TIAN Huang-hua;WANG Qing-qing(Wuxi Eighth People's Hospital,Wuxi 214011,China)

机构地区：[1]无锡市第八人民医院,214011

出　　处：《中国实用医药》2023年第23期112-115,共4页China Practical Medicine

摘　　要：目的 研究在小儿眼科手术治疗中的麻醉方案,重点对比分析瑞芬太尼复合七氟烷喉罩全身麻醉(全麻)与芬太尼复合丙泊酚气管插管全麻的效果,从而优化麻醉方案。方法 60例行小儿眼科手术的患儿,按照随机数字表法分成实验组与对照组,每组30例。实验组实施瑞芬太尼复合七氟烷喉罩全麻,对照组实施芬太尼复合丙泊酚气管插管全麻。比较两组麻醉诱导前(T0)、麻醉诱导后(T1)、喉罩置入前(T2)、喉罩置入后5 min(T3)、手术结束时(T4)、喉罩拔除前(T5)、喉罩拔除后10 min(T6)的平均动脉压、心率、相对危险度值, T2~T5的每分钟通气量与呼气末二氧化碳分压,手术时间、苏醒时间、喉罩拔除时间、麻醉后监测治疗室(PACU)停留时间,苏醒期躁动发生率。结果 T0、T1、T2时,两组患儿的平均动脉压、心率、相对危险度值比较,差异无统计学意义(P>0.05);T3、T4、T5、T6时,实验组患儿的平均动脉压、心率、相对危险度值均低于对照组,差异有统计学意义(P<0.05)。实验组患儿T3、T4时的每分钟通气量低于对照组,呼气末二氧化碳分压高于对照组;T5时的每分钟通气量低于对照组,差异有统计学意义(P<0.05)。两组T2时的每分钟通气量及T2、T5时的呼气末二氧化碳分压比较,差异无统计学意义(P>0.05)。实验组患儿的苏醒时间、喉罩拔除时间以及PACU停留时间分别为(5.12±1.90)、(7.55±1.12)、(26.54±4.32)min,均短于对照组的(7.64±2.32)、(9.65±2.12)、(31.44±4.59)min,差异具有统计学意义(P<0.05);实验组患儿的手术时间为(30.23±5.32)min,与对照组的(30.54±5.65)min比较,差异无统计学意义(P>0.05)。实验组患儿的苏醒期躁动发生率为0,低于对照组的13.33%(4/30),差异有统计学意义(P<0.05)。结论 瑞芬太尼复合七氟烷喉罩全麻用于小儿眼科手术,有助于保障呼吸、循环的稳定,也对术后苏醒有较好的支持和保障,值得推广。Objective To study the implementation of anesthesia program in pediatric ophthalmic surgery,focusing on the comparison of the effect of remifentanil combined with sevoflurane laryngeal mask general anesthesia and fentanyl combined with propofol endotracheal intubation general anesthesia,so as to optimize the anesthesia program.Methods A total of 60 children undergoing pediatric ophthalmic surgery were divided into an experimental group and a control group according to random numerical table,with 30 cases in each group.The experimental group underwent remifentanil combined with sevoflurane laryngeal mask general anesthesia,and the control group underwent fentanyl combined with propofol endotracheal intubation general anesthesia.Both groups were compared in terms of mean arterial pressure,heart rate and relative risk values before anesthesia induction(T0),after anesthesia induction(T1),before laryngeal mask insertion(T2),5 min after laryngeal mask insertion(T3),at the end of surgery(T4),before laryngeal mask removal(T5)and 10 min after laryngeal mask removal(T6),minute ventilation volume and end-tidal carbon dioxide partial pressure at T2-T5,operative time,recovery time,laryngeal mask removal time,post-anesthesia care unit(PACU)stay time after anesthesia,and the incidence of agitation during recovery.Results At T0,T1 and T2,there was no statistically significant difference in mean arterial pressure,heart rate and relative risk value between the two groups(P>0.05).At T3,T4,T5 and T6,the mean arterial pressure,heart rate and relative risk values of the experimental group were lower than those of the control group,and the differences were statistically significant(P<0.05).The minute ventilation volume at T3 and T4 in the experimental group was lower than that in the control group,and the end-tidal carbon dioxide partial pressure was higher than that in the control group;the minute ventilation rate in the experimental group at T5 was lower than that in control group;the differences were statistically significant(P<0.05

关 键 词：瑞芬太尼 七氟烷 喉罩全身麻醉 小儿眼科手术 

分 类 号：R726.1[医药卫生—儿科]