瑞芬太尼复合异丙酚全凭静脉麻醉用于儿科手术

目的:观察瑞芬太尼(remifentanil,REM)复合异丙酚全凭静脉麻醉用于儿科手术的临床效果及安全性。方法:ASAⅠ～Ⅱ级择期手术患儿30例,单次静脉给予异丙酚1.0mg.kg-1,使其入睡。麻醉诱导给予异丙酚2.5mg.kg-1,REM1μg.kg-1,诱导完成3min后置入喉罩,保留自主呼吸,麻醉维持给予异丙酚9.0mg.kg-1.h-1,REM0.1μg.kg-1.min-1持续输注。观察麻醉期间血流动力学(HR及BP)及呼吸功能(SpO2及RR)的变化,记录麻醉期间并发症和用药情况,以及术毕停药后患儿清醒的时间。结果:全组30例病人麻醉效果均满意,手术时间(64±24)min,术毕停用REM后患儿清醒时间(10±5)min。整个麻醉期间HR、BP、SpO2及RR各时间点比较均无统计学差异(P均>0.05)。结论:瑞芬太尼复合异丙酚全凭静脉麻醉可满足儿科手术的麻醉要求,但应密切注意呼吸功能变化。

Total Intravenous Anesthesia with Remifentanil and Propofol for Paediatric Surgery

Objective To observe the efficacy and safety of the total intravenous anesthesia （TIVA） with remifentanil and propofol for paediatric surgery. Methods Thirty ASA physical status Ⅰ～Ⅱ patients undergoing selective paediatric surgery, were all received a single intravenous injection of propofol 1.0 mg·kg^-1 to make them fall asleep. Anesthesia was induced with prepofol 2.5 mg·kg^-1 and REM 1 mg·kg^-1 ;then inserted laryngeal mask with spontaneous respiration three minutes after anesthsia induction. Propofol 9.0 mg·kg^-1·h^-1 and REM 0.1μg·kg^-1·min^-1 were continuously infused during maintenance of anesthesia. The changes of hemodynamic and respiratory parameters were observed. Complications during operation, medication and the recovery time post operation were recorded. Results The effects of anesthesia on all patients were satisfactory. The duration of operation were （64 ±24） min and the consciousness recovery time were （ 10±5） min after operation. Throughout the anesthesia, HR, SBP, DBP, SpO2 and RR were stable at each time point, （P 〉 0. 05）. Conclusion Total intravenous anesthesia with remffentanil and propofol were satisfactory for paediatric surgery, more attention should be pay to the change of respiratory function.