舒芬太尼静脉复合麻醉在门诊内镜治疗小儿结肠息肉中的临床观察

目的观察舒芬太尼复合丙泊酚静脉麻醉在门诊内镜治疗小儿结肠息肉中的麻醉效果。方法回顾性分析应用于本院肠镜下行息肉切除术患儿的静脉麻醉方法，将患儿按不同的麻醉方法分为单纯丙泊酚麻醉组（P组）、氯胺酮复合丙泊酚麻醉组（K组）、舒芬太尼复合丙泊酚麻醉组（S组），每组各30例。麻醉诱导P组患儿静脉滴注丙泊酚2．5mg／kg；K组先后静脉滴注氯胺酮1mg／kg，丙泊酚2mg／kg；S组先后静脉滴注舒芬太尼0．15μg／kg，丙泊酚2mg／kg。术中按需追加丙泊酚0．5～1mg／kg。观察记录3组患儿的麻醉效果、手术时间、苏醒时间、术中发生体动次数及丙泊酚使用总量：观察呼吸抑制、苏醒期躁动、呛咳及恶心呕吐等不良反应发生情况。结果K、S组麻醉效果的优良率明显高于P组（P〈0．05），K、S组的麻醉效果比较，差异无统计学意义（P〉0．05）；3组患儿的手术时间比较，差异无统计学意义（P〉0．05），P、S组的苏醒时间明显短于K组（P〈0．05），K、S组的体动次数及丙泊酚使用总量均明显少于P组（P〈0．05）；P组术中呼吸抑制的发生率明显高于K、S组（P〈0．05），K组苏醒期躁动的发生率明显高于P、S组（P〈0．05），3组患儿呛咳、恶心呕吐及肌肉僵直等不良反应发生情况比较，差异无统计学意义（P〉0．05）。结论舒芬太尼复合丙泊酚静脉麻醉应用于门诊小儿内镜下肠息肉切除术能为手术提供较好的镇静、镇痛效果，在临床应用中不失为一种较为安全有效的麻醉方法。

Clinical observation of sufentanil vein combined anesthesia in outpatient endoscopic treating colonic polyps in children

Objective To observe the anesthetic effect of sufentanil combined with propofol for intravenous anesthesia in outpatient endoscopic treating colonic polyps in children. Methods The intravenous anesthetic methods applied on polypectomy in children under enteroscope in our hospital were retrospective analyzed.Patients were divided into the the pure propofol anesthesia group （the group P,n=30）,the ketamine combined with propofol group （the group K,n=30） and the sufentanil combined with propofol anesthesia group （the group S,n=30） according to different anesthetic meth- ods.The group was given propofol of 2.5 mg/kg with intravenous injection,the group K was given successively ketamine of 1 mg/kg combined with propofol of 2 mg/kg with intravenous injection while the group S was given successively sufentanil of 0.15 Ixg/kg combined with propofol of 2 mg/kg with intravenous injection for anesthesia induction.Addi- tional propofol 0.5-1 mg/kg was administered according to the need in operation.The anesthesia effect,operation time,recovery time,body movement times during operation and total amount of propofol used of children in the three groups were observed and recorded.The occurrence of adverse reactions such as respiratory depression,agitation during awak- ening, choking cough,nausea and vomiting were observed. Results The excellent and good rate of anesthetic effect of the group K and the group S were significantly higher than that of the group P （P〈0.05）,while there was no statistical dif- ference of anesthesia effect in the group K and the group S （P〉0.05）;there was no statistical difference of operation time among the three groups （P〉0.05）,the recovery time of the group P and the group S was significantly shorter than that of the group K （P〈0.05）,body movement times and total amount of propofol used in the group K and the group S were sig- nificantly fewer than that of the group P （P〈0.05）;the occurrence rate of respiratory depression during operation of the group P was significantly higher than that of the group K and the group S （P〈0.05）,the occurrence rate of awakening agitation of the group K was significantly higher than that of the group P and the group S （P〈0.05）,there was no statis- tical difference of the occurrence of adverse reactions such as choking cough,nausea,vomiting and muscle rigidity in the three groups （P〉O.05）. Conclusion Sufentanil combined with propofol with intravenous anesthesia applied on polypecto- my in children under enteroscope can provide better sedation and analgesia effect for the operation,and it can be regarded as a relatively safe and effective anesthesia method in clinical application.