瑞芬太尼全凭静脉麻醉用于小儿等离子刀扁桃体腺样体手术

目的:探讨小儿等离子刀扁桃体腺样体手术中应用瑞芬太尼全凭静脉麻醉的价值。方法:择期行等离子刀扁桃体腺样体手术的患儿40例,ASA级,随机分为观察组和对照组,观察组瑞芬太尼0.15~0.25μg.kg-1.min-1微量泵持续输注,对照组持续吸入异氟醚0.7%~2.0%。观察诱导前、插管后5min、手术开始后20min和拔管后20min血压、心率的变化。观察自主呼吸恢复时间、苏醒时间、拔管时间、拔管后20min清醒程度评分和拔管后恢复情况。结果:两组患儿围手术期循环平稳,观察组自主呼吸恢复时间、苏醒时间、拔管时间均明显短于对照组(P<0.05),观察组清醒程度明显优于对照组(P<0.05)。结论:瑞芬太尼全凭静脉麻醉,与异氟醚静吸复合麻醉比较,苏醒迅速,清醒完全,能满足小儿等离子刀扁桃体腺样体手术的麻醉要求。

Total intravenous anesthesia with remifentanil during tonsillectomy and adenoidectomy in children with plasma radiofrequency ablation

Objective:To investigate the value with total intravenous anesthesia with remifentanil in children undergoing tonsillectomy and adenoidectomy with plasma radiofrequency ablation.Methods:Forty ASAⅠchildren undergoings selective tonsillectomy and adenoidectomy with plasma radiofrequency ablation were randomly divided into two groups.The anesthesia was continued with a continuous infusion of remifentanil 0.15～0.25 μg·kg-1·min-1 in experiment group.Maintenance of control group was obtained with isoflurane 0.7%～2.0%.The following parameters were monitored:SBP,DBP and HR before administration of anesthesia,5min after intubation,20min after the beginning of the operation and 20min after extubation,recovery time of respiratory,time of eye opening,time of extubation,conscious state score on 20min after extubation.Results:There was stable circulatory function during surgery in the two groups.Recovery time of respiratory,time of eye opening and time of extubation in experiment group were significantly earlier than those in control group(P<0.05).Compared to control group,conscious state score in experiment group was significantly higher(P<0.05).Conclusion:Total intravenous anesthesia of remifentanil can be applied safely in children undergoing tonsillectomy and adenoidectomy with plasma radiofrequency ablation.Compared to isoflurane anesthesia,postoperative recovery of total intravenous anesthesia of remifentanil is earlier and better.