瑞芬太尼复合异丙酚对小儿先天性白内障手术的麻醉效果

目的：探讨瑞芬太尼复合异丙酚对小儿先天性白内障的手术的麻醉效果。方法：先天白内障手术小儿30例，随机分为瑞芬太尼组（R组，n=15）和氯胺酮组（K组，n=15）。麻醉诱导采用异丙酚2．5mg／kg，维库溴铵0．1mg／kg，R组用瑞芬太尼1μg／kg，K组用氯胺酮1mg／kg，气管插管后机械通气。R组持续静脉输注异丙酚2mg／（kg·h）＋瑞芬太尼4μg／（kg·h）复合液，K组持续静脉输注异丙酚2ms／（kg·h）＋氯胺酮2mg／（kg·h）复合液。记录停药至拔管时间、拔管后再入睡、离开手术室时间、外科医生评价满意度和不良反应。结果：与K组相比，R组麻醉效果好，苏醒时间短，苏醒后再入睡率低，外科医生满意度高，小儿不良反应低（P〈0．05）。结论：瑞芬太尼复合异丙酚麻醉为小儿先天性白内障手术提供稳定的血流动力学状态、快速苏醒拔管和较高的满意度。

Anaesthesia with remifentanil and propofol during congenital cataract operation in children

Objective： To investigate the anesthetic effect of remifentanil combined with propofol during the congenital cataract operation in children. Methods： Thirty pediatric patients with congenital cataract were randomly divided into Remifentanil group （ n = 15 ） and Ketamine group （ n = 15 ）. Anesthesia was induced with propofol （2.5 mg/kg）, vecuronium （0. 1mg/kg）, and remifentanil （ 1 μg/kg） or ketamine （ 1mg/kg）, and was maintained with propofol （2 mg/kg, h） , and continuous infusion of remifentanil （4 μg/kg. h） or ketamine （2 mg/ kg. h）. Results： Compared with Ketamine group, in Remifentanil group, the effect of anaesthesia was better, analepsia time was shorter, re - sleep rate after analepsia was lower, surgeon satisfaction degree was higher, and adverse reaction was lower （ P 〈 0.05 ）. Conclusion ： The anesthetic effect of remifentanil combined with propofol is more potent than that of ketamine with propofol. Remifentanil can offer superior intraoperative haemodynamics stability, faster analepsia and extubation, and higher satisfaction degree.