瑞芬太尼与芬太尼在小儿扁桃体切除术中的应用

目的比较观察瑞芬太尼与芬太尼在小儿扁桃体切除术中的应用效果。方法2008年1月~2009年1月,58例行小儿扁桃体切除术的患儿随机分为瑞芬太尼组和芬太尼组,每组29例,观察两组的MAP、HR以及术毕停药后患儿呼吸恢复时间、睁眼时间、拔管时间,记录恶心呕吐、躁动发生情况。结果两组T2、T3、T4和T5时MAP、HR均较T1时明显增高,差异有统计学意义（P〈0.05）。并且,瑞芬太尼组T2、T3、T4和T5时MAP、HR均明显低于芬太尼组（P〈0.05）。瑞芬太尼组术后呼吸恢复时间、睁眼时间、拔管时间均明显短于芬太尼组,两组比较差异有统计学意义（P〈0.05）。瑞芬太尼组术后躁动发生率明显高于芬太尼组,两组比较差异有统计学意义（P〈0.05）;而恶心呕吐发生率,两组比较无统计学意义（P〉0.05）。结论瑞芬太尼可安全有效的应用于小儿扁桃体摘除术的麻醉,具有较好的临床应用价值。

The application of remifentanil and fentanyl in tonsillectomy of children

Objective To compare and observe the application effect of remifentanil and fentanyl in tonsillectomy of child. Methods From January 2008 to January 2009, 58 cases children with tonsillectomy were randomly classified into remifentanil group with 29 cases and fentanyl group with 29 cases. The MAP, HR, respiration recovery time, eyes open time, extubation time, nausea and vomiting rate and restlessness rate were observed. Results Compared with T1, MAP and HR at T2, T3, T4, T5 in two groups were significantly increased（P〈0. 05）. Moreover, MAP and HR at T2, T3, T4, T5 in remifentanil group were significantly higher than those in fentanyl group（P〈0. 05 ）. The respiration recovery time, eyes open time, extubation time in remifentanil group were significantly shorter than those in fentanyl group（ P〈0. 05）. The restlessness rate in remifentanil group were significantly higher than that in fentanyl group（ P〈0. 05 ） ,while there was no significant defferenc in nausea and vomiting rate between the two groups （ P〉0. 05 ）. Conclusion The application of remifentanil in tonsillectomy of children is recommendable.