咪唑安定复合瑞芬太尼丙泊酚用于小儿腭裂修复术麻醉的临床观察

目的观察咪唑安定复合瑞芬太尼丙泊酚麻醉是否较单纯瑞芬太尼丙泊酚麻醉在小儿腭裂修复术中使用更为安全合理。方法30例择期行腭裂修复术患儿,随机分为两组：Ⅰ组为咪唑安定复合瑞芬太尼丙泊酚麻醉组（MRP组）,Ⅱ组为瑞芬太尼丙泊酚麻醉组（RP组）。每组15例。比较两组麻醉各时段血流动力学变化、瑞芬太尼丙泊酚使用剂量及苏醒情况。结果两组在术中维持及拔管前血压及心率较基础值均降低（P〈0.05）;Ⅱ组在插管时血压升高明显,与Ⅰ组相比统计学上有意义（P〈0.05）。Ⅱ组使用丙泊酚量较Ⅰ组显著增加（P〈0.05）,瑞芬太尼用量也有增加趋势但统计学上无意义（P〉0.05）。Ⅰ组拔管期躁动的患儿比例也较低。两组拔管时间差异统计学上无意义（P〉0.05）。结论瑞芬太尼丙泊酚麻醉是一种有效的小儿腭裂麻醉方法,而复合咪唑安定则更为安全、经济。

Clinical investigation of Midazolam combined Remifential and Propofol in pediatric patients undergoing palatorrhaphy

Objective To compare the clinical efficacy and safety of midazolam/remifentail/propofol anesthesia with remifentail/propofol anesthesia in pediatric patients undergoing palatorrhaphy. Methods Thirty pediatric patients undergoing palatorrhaphy were randomized into midazolam/remifentail/propofol group （group MRP） and remifentail/propofol group （group RP）. Each group consisted of 15 cases. The intraoperative hemodynamic parameters,the dose of remifentail/propofol and recovery profile were compared. Results MAP during tracheal intubation was significantly higher as compared with preoperative （P〈0.05） in group RP,while during maintainence of operative and before tracheal extubation were lower as compared with preoperative （P〈0.05） in two groups. HR was significantly lower at maintainence of operative and before tracheal extubation in two groups. The dose of propofol was significantly higher in group RP than that in group MRP （P〈0.05）,and there was fewer children fidgesting in group MRP than that in group RP. There was no significant difference about the time from stopping using remifentail and propofol to tracheal extubation. Conclusion Remifentanil/propofol is an effective anesthesia in pediatric patients undergoing palatorrhaphy,but combined midazolam will be more safety and cheaper.