丙泊酚复合瑞芬太尼全凭静脉麻醉在小儿神经外科手术的应用

目的对比研究静吸复合麻醉和全凭静脉麻醉在小儿神经外科麻醉的应用。方法40例择期手术患儿随机分为2组,静吸复合组20例,全凭静脉麻醉组20例。静吸复合组诱导后给予异丙酚3mg·kg^-1·h^-1,同时吸入1%～2%的七氟烷维持,全凭静脉组诱导后给予异丙酚8mg·kg^-1·h^-1,瑞芬太尼0.25ug·kg^-1·min^-1持续泵入,根据血压调节,直至手术结束。观察麻醉维持及苏醒、拔管时的血液动力学变化,记录拔管、苏醒以及清醒时间,苏醒期躁动以及术后恶心呕吐发生率。结果全凭静脉麻醉术中血液动力学较平稳,拔管时间、苏醒时间以及清醒时间明显短于静吸复合麻醉组,同时苏醒期躁动和术后恶心呕吐发生率低。结论全凭静脉麻醉较静吸复合麻醉更适合应用于小儿神经外科手术麻醉。

The study on using combination propofol with remifentanil in pediatric neurosurgery

Objective To compare the use of the total intravenous anesthesia （TIVA） with intravenous inhalation （ⅡA） in pediatric neurosurgery. Methods Fourty patients scheduled for neurosurgery divided randomly into two equal groups,each group had twenty patients.The patients in IIA group were given a sustained Ⅳinfusion propofol 3mg·kg^-1·h^-1 of combined with inhalation 1%-2% sevofluranee after induction.The patients of TIVA were given a sustained Ⅳinfusion 8mg·kg^-1·h^-1 of propofol, 0.25ug·kg^-1·h^-1of remifentanil with an injection pump after induction and stop at the end of operation.Hemodynamic parameters were continuously monitored.The time of extrdule,recovery from the anesthesia and awaken,adverse reaction were noted down. Results Hemodynamic parameters was more stable in TIVA group during neurosurgery,the time of recovery,extratuble and awaken in TIVA group was shorter than that in ⅡA group.The incidence of postoperative nausea and vomiting was lower. Conclusion Total intravenous anesthesia is more suitable for pediatric neurosurgery.