丙泊酚与瑞芬太尼或氯胺酮复合麻醉在小儿气管异物取出术中的应用

目的 探讨丙泊酚复合瑞芬太尼或氯胺酮复合麻醉在小儿气管异物取出术中的麻醉效果.方法 选择气管异物取出术患儿40例,随机分为丙泊酚复合氯胺酮组(K组)和丙泊酚复合瑞芬太尼组(R组).监测记录入室到苏醒期间的血压,心率,血氧饱和度及呼吸频率;记录术中术后不良反应:呛咳、喉痉挛、屏气、SpO2<90%、术后恶心呕吐、舌后坠、躁动的情况;记录出入镜次数、手术时间和麻醉恢复时间.结果 两组各时点以及组间的MAP、HR 、SpO2 及RR比较差异无显著性.K组术中呛咳、屏气,术后恶心呕吐、躁动的发生率高于S组(P<0.05).K组的出入镜次数较S组多(P<0.05),手术时间以及麻醉恢复时间均长于S组(P<0.05).结论 丙泊酚与瑞芬太尼复合麻醉安全有效用于小儿气管异物取出术,具有血流动力学变化平稳,不良反应少,手术及麻醉恢复时间短的特点.

Evaluation of Propofol-remifentanil or Propofol-ketamine Total Intravenous Anaesthesia in Children Undergoing Tracheal Foreign Body Extraction

Objective: To observe the anaesthesia effect of the foreign body extraction in trachea of children by propofol combined with remifentanil or ketamine intravenous anaesthesia.Method: 40 children wound be performed for tracheal foreign body extraction,were randomly divided into two groups: propofol-ketamine group(group K,n=20) and propofol-remifentanil group(group R,n=20).HR,MAP,SpO2,RR were recorded during anesthesia.To record the perioperative and postoperative adverse reaction: cough,laryngospasm,breathholding,SpO2<90%,PONV,glossocoma,dysphoria.The number of bronchofiberscope get in and out of trachea was recorded.and then recorded the operation time and anesthesia recovery time.Result: There’s no statistical significance in MAP,HR,SpO2 and RR within the group or between two groups.Group K in comparison with group R concerning the incidence of cough,breath holding,PONV,dysphoria were higher(P<0.05).The number of bronchofiberscope get in and out of tracheal,group K was more than group R(P<0.05).The comparison of the operation time and anesthesia recovery time group K was longer than group R(P<0.05).Conclusion: Propofol combined remifentanil be used safely and effectively in total intravenous anaesthesia of children undergoing tracheal foreign body extraction,decrease the adverse reaction,the operation time and anesthesia recovery time was shorter.