瑞芬太尼丙泊酚静脉麻醉用于小儿脑瘫矫形手术的临床研究

目的:观察瑞芬太尼丙泊酚在小儿脑瘫后遗症髋内收畸形矫正术中的麻醉效果。方法:选择ASAⅠ～Ⅱ的患儿(均为男性)30例,随机分为两组,每组15例。Ⅰ组:采用瑞芬太尼0.2～0.25μg/(kg.min)复合丙泊酚0.08 mg/(kg.min)持续静脉泵注。Ⅱ组:采用静脉单次推注氯胺酮2 mg/kg、丙泊酚1 mg/kg。根据手术需要追加氯胺酮1 mg/kg。结果:瑞芬太尼组较氯胺酮组术中BP、HR明显平稳(P<0.05),且术后苏醒时间短,精神症状少。结论:瑞芬太尼复合丙泊酚静脉麻醉具有术中患儿循环波动小、苏醒及时、清醒快、不良反应发生率低等优点。

Clinical studies of remifentannil propfol intravenous anesthesia for children cerebral palsy orthopaedic operation

Objective To evaluate the clinical efficacy and safety of remifentanil propfol intravenous anesthesia for children cerebral palsy sequela hip adduction deformity orthopaedic operation.Method Thirty ASA Ⅰ~Ⅱchildren（All boy） were randomly divided into two groups,15 patients in each group.Anesthesia was maintained with 0.2~0.25 μg/（kg·min） remifentanil combined with 0.08 mg/（kg·min） propfol micro-pump infusion in group Ⅰ,but in group Ⅱ with an intravenous injection of 2 mg/（kg ketamine）,1 mg/（kg propfol）.According to the need of operation,additional dose of ketamine 1 mg/kg.Results BP and HR during the operation in remifentanil group is more stable than in ketamine group（P0.05）,and the postoperative waking time was shorter,with less psychotic symptoms.Conclusion Remifentanil combined with propfol intravenous anaesthesia has the advantages such as with little changes incirculatory system during operation,timely awaken,and low rate of adverse reactions.