瑞芬太尼-异丙酚全凭静脉麻醉对急性阑尾炎患儿应激反应及麻醉复苏的影响

目的:探讨分析瑞芬太尼-异丙酚全凭静脉麻醉对急性阑尾炎患儿应激反应及麻醉复苏的影响。方法:我院2010年3月—2012年4月收治儿童急性阑尾炎患者106例,采用随机数法分成瑞芬太尼—异丙酚组(R组)和芬太尼—异丙酚组(F组),比较两组患儿术中有创平均动脉压(MAP)、心率(HR)、去甲肾上腺素(NE),皮质醇(Cor)、促肾上腺皮质激素(ACTH)等应激指标,记录手术完成后两组患儿的镇静评分(Ramsay评分)等复苏情况。结果:手术开始后两组在手术开始10 min(T1)、30min(T2)的NE、E、Cor、ACTH的浓度均比术前5 min(T0)高,并且术中各时点R组的应激指标水平均显著低于F组;拔管后30 min R组Ramsay评分明显小于F组,拔管60min后R组FLACC评分明显小于F组,差异均具有统计学意义(P<0.05)。结论:瑞芬太尼—异丙酚全凭静脉麻醉可以有效抑制急性阑尾炎患儿的术中应激反应,使手术更加安全;并且患儿术后麻醉复苏较好,值得在临床上推广。

Effect of total intravenous anesthesia with Remifentanil-propofol on the stress response and anesthetic recovery in patients with acute appendicitis in children

Objective： To investigate the effect of total intravenous anesthesia with Remifentanil-propofol on the stress response and anesthetic recovery in patients with acute appendicitis inchildren.Methods： A retrospective analysis of 106 cases of patients with acute appendicitis in children admitted to our hospital in March 2010-2012 April,the random number to be divided into two groups,53 cases remifentanil-propofol group（R group）,and the remaining 53 cases of fentanyl propofol group（F group）,comparing two groups of patients,mean arterial pressure（MAP）,heart rate（HR）,go to norepinephrine（NE）,and cortisol（Cor）,adrenocorticotropic hormone（ACTH）reflect the stress indicators.Results： After the start of the surgery,the two groups in the T1,T2,T3 point in time of NE,E,Cor,ACTH concentration than T0 is high,and surgery in various concentrations at each time point R group were significantly lower than in group F;pull tube 30min R group Ramsay score significantly less than group F,and R group FLACC score was significantly less than 60min after extubation group F,and the differences were statistically significant（P0.05）.Conclusion： Remifentanil propofol TIVA can effectively inhibit the stress response in children with acute appendicitis patients make surgery safer and better postoperative anesthesia recovery worth in clinical practice.