亚剂量瑞芬太尼联合丙泊酚在小儿静脉麻醉维持中的应用价值及安全性  

Application value and safety of sub-dose remifentanil combined with propofol in the maintenance of intravenous anesthesia in children

作　　者：罗韵 徐国亭[1] Luo Yun;Xu Guoting(Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院麻醉与围手术期医学科手术部,南阳473000

出　　处：《国际医药卫生导报》2024年第2期314-318,共5页International Medicine and Health Guidance News

基　　金：河南省医学科技攻关项目(LHGJ202101126)。

摘　　要：目的观察亚剂量瑞芬太尼联合丙泊酚在小儿静脉麻醉维持中的应用效果及安全性。方法本文为随机对照试验,前瞻性选取2021年1月至2023年1月期间至南阳医学高等专科学校第一附属医院接受手术的125例患儿为研究对象,应用抽签法将其分为3组。常规剂量组中患儿男女比为22/20、年龄(9.45±1.23)岁,手术类型:22例为疝气手术,10例为扁桃体切除术,10例为骨科手术;亚剂量组中患儿男女比为20/21、年龄(9.33±1.16)岁,手术类型:22例为疝气手术,10例为扁桃体切除术,9例为骨科手术;低剂量组中患儿男女比为23/19、年龄(9.52±1.31)岁,手术类型:21例为疝气手术,11例为扁桃体切除术,10例为骨科手术。常规剂量组术中予以1.00μg/kg瑞芬太尼配合丙泊酚维持麻醉,低剂量组术中予以0.25μg/kg瑞芬太尼配合丙泊酚维持麻醉,亚剂量组术中予以0.50μg/kg瑞芬太尼配合丙泊酚维持麻醉。比较3组患儿围手术期基础体征变化情况,术后苏醒、镇痛情况及麻醉相关不良反应发生情况。采用χ^(2)检验、F检验、独立样本t检验。结果术前,3组患儿的心率(HR)、平均动脉压(MAP)差异均无统计学意义(均P>0.05);麻醉后10 min,亚剂量组的HR为(73.45±5.22)次/min,MAP为(79.11±5.33)mmHg(1 mmHg=0.133 kPa),高于常规剂量组[(70.14±5.17)次/min、(76.62±5.41)mmHg](均P<0.05),与低剂量组[(74.49±5.23)次/min、(80.25±5.41)mmHg]比较差异均无统计学意义(均P>0.05);气管插管时,亚剂量组的HR为(80.33±5.26)次/min,MAP为(81.25±5.45)mmHg,低于低剂量组[(83.28±5.41)次/min、(84.49±5.18)mmHg](均P<0.05),与常规剂量组[(79.45±5.31)次/min、(80.44±5.32)mmHg]比较差异均无统计学意义(均P>0.05);插管后30 min,亚剂量组的HR为(79.45±10.13)次/min,MAP为(80.23±10.16)mmHg,高于常规剂量组[(72.15±10.49)次/min、(73.22±10.25)mmHg]、低于低剂量组[(86.39±10.22)次/min、(87.24±10.18)mmHg](均P<0.05);术毕,亚剂量组的HR为(80.24�Objective To observe the efficacy and safety of sub-dose remifentanil combined with propofol in pediatric intravenous anesthesia maintenance.Methods This was a randomized controlled trial.A total of 125 children who underwent surgery in the First Affiliated Hospital of Nanyang Medical College from January 2021 to January 2023 were prospectively selected as the study objects and were divided into 3 groups by drawing lots.In the conventional dose group,the ratio of boys to girls was 22/20,the age was(9.45±1.23)years old,and the types of surgery were as follows:22 cases of hernia surgery,10 cases of tonsillectomy,and 10 cases of orthopedic surgery.In the sub-dose group,the ratio of boys to girls was 20/21,the age was(9.33±1.16)years old,and the types of surgery were as follows:22 cases of hernia surgery,10 cases of tonsillectomy,and 9 cases of orthopedic surgery.In the low-dose group,the ratio of boys to girls was 23/19,and the age was(9.52±1.31)years old,and the types of surgery were as follows:21 cases of hernia surgery,11 cases of tonsillectomy,and 10 cases of orthopedic surgery.The conventional dose group was given 1.00μg/kg remifentanil combined with propofol to maintain anesthesia,the low-dose group was given 0.25μg/kg remifentanil combined with propofol to maintain anesthesia,and the sub-dose group was given 0.50μg/kg remifentanil combined with propofol to maintain anesthesia.The changes in basic physical signs during the perioperative period,postoperative recovery,pain relief,and anesthesia-related adverse reactions of the 3 groups were compared.χ^(2) test,F test,and independent sample t test were used.Results Before surgery,there were no statistically significant differences in the heart rate(HR)and mean arterial pressure(MAP)among the 3 groups(both P>0.05).Ten min after anesthesia,the HR and MAP of the sub-dose group were(73.45±5.22)beats/min and(79.11±5.33)mmHg(1 mmHg=0.133 kPa),which were higher than those of the conventional dose group[(70.14±5.17)beats/min and(76.62±5.41)mmHg](both P<0.05),b

关 键 词：瑞芬太尼 丙泊酚 小儿静脉麻醉 麻醉效果 麻醉安全性 

分 类 号：R726.1[医药卫生—儿科]