瑞芬太尼、丙泊酚复合麻醉在儿童扁桃体切除术中的应用

目的探讨瑞芬太尼、丙泊酚复合麻醉在儿童扁桃体切除术中的应用及临床疗效。方法将我院2009年1月至2012年2月收治的行扁桃体切除术患儿50例,随机分为观察组与对照组,每组25例,观察组患儿采用瑞芬太尼、丙泊酚复合麻醉,对照组采用芬太尼、丙泊酚复合麻醉。监测两组麻醉前、手术开始、手术开始20min、拔管时患者平均动脉压（MAP）及心率（HR）,记录停药后患儿呼吸,意识恢复时间,术毕至拔管时间,以及不良反应的发生情况。结果两组患儿麻醉过程平稳,平均手术时间（31±3）min,术中顺利,观察组患儿术中循环稳定,优于对照组,术毕吞咽恢复时间、苏醒时间、拔管时间均明显少于对照组,两组比较差异有统计学意义（P〈0.05）。结论瑞芬太尼、丙泊酚复合麻醉下儿童扁桃体切除能有效抑制应激反应,麻醉深度可控制性强,血流动力学变化平稳,术毕苏醒迅速完全,不良反应少,临床疗效确切。

Remifentanil combined with propofol anesthesia for Children tonsillectomy

Objective To study the application of remifentanil, propofol anesthesia and its clinical efficacy in children undergoing tonsillectomy.Methods 50 cases of tonsillectomy in children in our hospital from 2009 January to 2012 February were, were randomly divided into observation group and control group, 25 cases in each group, the observation group were treated with remifentanil, propofol anesthesia, the control group with fentanyl, propofol anesthesia.Monitoring the two groups before anesthesia, operation began operation, mean arterial pressure in patients with 20 min start, extubation （MAP） and heart rate （HR）, to record the breath after discontinuation of children, the consciousness recovery time, surgery to extubation time, and adverse effect.Results The two groups were stable during the operation period, the average operation time was （31±3） min, with smooth, children of observation group during the cycle stability, better than the control group, postoperative dysphagia recovery time, recovery time, extubation time was significantly less than that in the control group, the difference between the two groups has statistical significance （P0.05）.Conclusion Remifentanil, propofol anesthesia children tonsil resection can effectively inhibit the stress response, the depth of anesthesia and controllable, hemodynamic changes smoothly, analepsia quickly and completely, less adverse reactions, clinical curative effect.