不同麻醉药物在儿童气管插管中的应用比较

目的研究比较小剂量芬太尼和瑞芬太尼对患儿直接喉镜经口气管插管应激反应的影响。方法60例择期五官科手术的惠儿，随机分为A组（瑞芬太尼组）和B组（芬太尼组），每组各30例。气管插管前采用盲法分别应用静脉注射异丙酚、维库溴铵、咪唑安定，以及瑞芬太尼或芬太尼。观察诱导前、诱导后1min、气管插管后2、5min的血流动力学变化。结果两组诱导后平均动脉压（MAP）和心率（HR）值均较诱导前下降（P〈0．05）。气管插管后2、5min时A组血流动力学变化幅度明显小于B组（P〈0．05）。结论使用瑞芬太尼可使患儿在直接喉镜经口气管插管应激反应时血流动力学更稳定，具有较好的麻醉效果和安全性。

Comparison of different anesthesia drugs in children with laryngoscopic orotracheal intubation

Objective To compare the effects of small-dose fentanyl and remifentanfl on stress responses to laryngoscopic orotracheal intubation in children. Methods 60 children were randomly divided into two groups, including remifentanil group（group A,n= 30）,fentanyl group（group B, n= 30）. The anaesthesia were induced with veeuronium and propofol followed by remifentanil or fentanyl. Laryngoscopy and tracheal intubation were performed later. The changes of haemodynamics were continuously recorded. Results MAP and HR in two groups at preintubatton were lower than baseline with no significance. Hemodynamic changes during intubation were significantly fewer in A group than that in B group （P〈0.05）. Conclusion Remifentanil could effectively depress the stress response to laryngoscopy and tracheal intubation in children.