舒芬太尼与瑞芬太尼复合麻醉在小儿扁桃体摘除术中的应用比较

目的：观察舒芬太尼或瑞芬太尼复合全麻在小儿扁桃体摘除术中的麻醉效果以及术后恢复情况。方法：40例择期行扁桃体摘除术患儿，ASAⅠ级，随机分为舒芬太尼组（S组，n=20）和瑞芬太尼组（R组，n=20）。S组以舒芬太尼0．2μg／kg诱导，以0．1μg／kg／h术中维持；R组以瑞芬太尼1μg／kg诱导，以0．1μg／kg／min术中维持。观察两组术中术后的血流动力学指标及术后恢复情况。结果：两组患儿围术期血流动力学稳定，差异无统计学意义（P〉0．05）。麻醉苏醒期S组镇静评分高于R组，躁动评分低于R组，差异有统计学意义（P〈0．05）。结论：舒芬太尼和瑞芬太尼复合全麻用于小儿扁桃体摘除术能有效地抑制小儿气管插管时的心血管反应，维持术中血流动力学稳定，舒芬太尼更能为患儿在麻醉恢复期提供充分镇痛镇静，降低术后躁动发生率，提高麻醉恢复质量和麻醉安全性。

A Comparison of the Anesthetic Effects of Sufentanil and Remifentanil for Children during Tonsillectomy

Objective To compare the anesthetic effects and early postoperative recovery quality of sufentanil with remifentanil for children during tonsillectomy. Methods Forty ASA grade Ⅰ children, scheduled for tonsillectomy under general anesthesia were randomly divided into sufentanil group （S, n=20） and remifentanil group （R, n=20） . Group S were given sufentanil 0.2ug/kg in anesthesia induction and maintained with 0.2ug/kg/h; Group R were given remifentanil 1ug/kg in anesthesia induction and maintained with 0. 1ug/kg/min. The changes of BIS, BP and HR were observed during anesthesia. The recovery of spontaneous breathing time, waking time, extubation time and complication related to recovery and extubation were recorded. VRS and Rammsay score were measured during postoperation. Result Both two groups had good hemodynamic stability during anesthesia induction and operative procedure. There were no significant differences on spontaneous breathing time, extubation time, waking time between the two groups during postoperative（P〉0.05）. But Group S had higher sedation score and lower agitation score compared to group R postoperatively（P〈0.05）. Conclusion Sufentanil and Remifentanil are safe and effective for children undergoing tonsillectomy. Sufentanil is better to remifentanil for the postoperative recovery quality.