瑞芬太尼在儿童扁桃体切除术麻醉中的应用

目的研究瑞芬太尼在儿童扁桃体切除术麻醉中的安全性和有效性。方法40例择期扁桃体切除手术的患儿,随机分为A组（瑞芬太尼组）和B组（芬太尼组）,每组20例。麻醉诱导采用静脉注射异丙酚、维库溴铵、咪唑安定,以及瑞芬太尼或芬太尼。麻醉维持采用吸入异氟醚以及持续静脉泵注瑞芬太尼或芬太尼。观察诱导前、诱导后1 min、气管插管后2 min、5 min的血流动力学变化,同时观察麻醉效果、麻醉苏醒及不良反应等情况。结果两组诱导后MAP和HR值均较诱导前下降。气管插管2 min和5 min时A组血流动力学变化幅度明显小于B组,A组的呼吸、睁眼和拔管时间少于B组,术后苏醒恢复状况也优于B组。结论使用瑞芬太尼的患儿术中血流动力学更稳定,术后苏醒快且副反应少,具有较好的麻醉效果和安全性。

Application of remifentanil in anaesth of children amygdalectomy

Objective To invesigate the safty and availability of remifentanil in anaesth of children with amygdalectomy. Methods 40 children with amygdalectomy were randomly divided into 2 groups, including Group A （remifentanil） and Group B （fentanyl）. Patients were induced with propofol, vecuronium bromide, midazolam and remifentanll （Group A） or fentanyl （Group B）. They were continuously maintained with isoflurane and emifentanll （Group A） or fentanyl （Group B）. All cases were observed the haemodynamics change at different time points, 1 min before and after the anesthesia induction, 2 min and 5 min after the tracheal intubation. Meanwhile anaesthesia effect, postanaesthesia recovery and adverse drug reaction were observed. Results In both groups, MAP and HR after anesthesia induction was lower than that before （P〈0.05）. At 2 min and 5 min after tracheal intubation, the amplitude of haemodynamics change in Group A was obviously smaller than that in Group B （P〈0.05）. The time of opening eyes after calling the patients and the extubation in Group A was fewer than that in Group B （P〈0.05）. The postanesthesia recovery in Group A was superior to that in Group B. Conclusion The haemodynamics of children with amygdalectomy applied remifentanil is stable. Remifentanil is effective and safe for anaesthesia.