小儿腹腔镜疝环结扎术中靶控输注瑞芬太尼复合丙泊酚的临床观察

目的:介绍瑞芬太尼复合丙泊酚麻醉在小儿腹腔镜疝环结扎术中的优点。方法:选择ASAⅠ~Ⅱ级、2~13岁、择期行腹腔镜疝环结扎术的患儿60例,随机分为观察组和对照组。观察组用瑞芬太尼、丙泊酚诱导和维持,对照组用芬太尼、丙泊酚诱导,丙泊酚和异氟醚维持。观察两组患者诱导及维持期血流动力学变化、气管拔管、苏醒时间及患儿拔管后呼吸困难、苏醒期躁动、术后恶心呕吐的发生率。结果:观察组围麻醉期的血流动力学较对照组平稳,气管拔管时间及苏醒时间均明显短于对照组(P0.05),术后苏醒躁动发生率明显少于对照组(P0.05)。结论:瑞芬太尼复合丙泊酚全凭静脉麻醉起效迅速,术中平稳,苏醒快速平顺,值得在小儿腹腔镜疝环结扎术中推广应用。

Clinical observation of target controlled infusion of remifentanil combined with propofol in laparoscopic hernial ring ligation in children

Objective:To introduce the advantages of the remifentanil combined with propofol anesthesia in laparoscopic hernial ring ligation in children.Methods:Sixty children with ASA Ⅰ-Ⅱ grade,2-13 years old were enrolled for laparoscopic hernial ring ligation.The observation group and the control group were randomly divided.Remifentanil and propofol were used for both inducement and maintenance in the observation group.In the control group,remifentanil and propofol were applied for the inducement while propofol and isoflurane were used for the maintenance.The variations of hemodynamics during the inducement and maintenance,extubation,palinesthesia time,the incidence of dyspnoea after the extubation,restlessness during analepsia period,postoperative nausea and vomiting of the two groups were observed.Results:The hemodynamics during the peri-anesthetic period in the observation group was more stable than that in the control group.The extubation time and palinesthesia time in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of restlessness was significantly lower compared with the control group(P<0.05).Conclusions:The intravenous anesthesia by remifentanil combined with propofol takes effect quickly and is stable during the operation,the palinesthesia is rapid and smooth,it is worth wide application in laparoscopic hernial ring ligation in children.