舒芬太尼在患儿腹腔镜手术麻醉诱导的应用

目的 探讨舒芬太尼在腹腔镜手术患儿靶控输注(TCI)麻醉诱导中的应用效果.方法 将长安医院收治的500例预接受腹腔镜手术的患儿均分为两组(每组250例),其中对照组采用芬太尼TCI进行麻醉诱导;观察组行舒芬太尼TCI麻醉诱导.对比两组患儿诱导时间、唤醒时间、拔管时间,术前(T0)、麻醉后(T1)、手术结束(T2)、术后24h(T3)、术后72h(T4)患儿应激反应(IL-6、CRP、COR)及不良反应发生情况.结果 与对照组相比,观察组患儿麻醉诱导时间明显缩短(t=12.352,P<0.05),唤醒时间及拔管时间均明显延长(t值分别为15.621、21.514,均P<0.05).观察组患儿T1、T2、T3、T4时体内IL-6、CRP、COR应激反应指标水平均明显低于对照组(t值为2.192~22.543,均P<0.05),患儿术后总不良反应发生率为24.00%,明显低于对照组(48.80%)(χ2=33.209,P<0.05).结论 对预接受腹腔镜手术的患儿进行舒芬太尼TCI麻醉诱导可显著改善患儿术后恢复效果,患儿应激反应及术后不良反应发生率低,安全性高.

Application of sufentanil in anesthesia induced laparoscopic surgery in children

Objective To explore the application effect of sufentanil target-controlled infusion (TCI) anesthesia in pediatric laparoscopic surgery.Methods Totally 500 patients intending to undergo laparoscopic surgery were divided into two groups with 250 cases in each. Cases in the control group were treated with TCI of fentanyl for anesthesia induction , and cases in the observation group were induced with TCI of sufentanil.The anesthesia induction time, wake-up time, extubation time, stress response including interleukin-6 (IL-6), C-reactive protein (CRP) and C-reactive protein (COR) before operation (T0), after anesthesia (T1), at the end of surgery (T2), 24h (T3) and 72h (T4) after surgery, and incidence of adverse reactions were recorded and compared .Results The anesthesia induction time of the observation group was shorter than that of the control group (t=12.352, P<0.05), but wake-up time and extubation time of the observation group were longer than those of the control group (t value was 15.621 and 21.514, respectively, both P<0.05).The levels of IL-6, CRP and COR at the time of T1,T2,T3 and T4 were significantly lower in the observation group than those in the control group (t value ranged 2.192-22.543, all P<0.05).The incidence of total adverse reactions in the observation group was 24.00%, which was significantly lower than the control group (48.80%) (χ2 =33.209,P<0.05).Conclusion Anesthesia induced with sufentanil TCI in children undergoing laparoscopic surgery can significantly improve postoperative recovery , reduce the stress response and postoperative adverse reactions with high safety .