雷米芬太尼和芬太尼静脉全麻用于小儿眼科手术的临床比较

目的:探讨雷米芬太尼和芬太尼用于患儿静脉全麻(TIVA)诱导、维持及苏醒的效果.方法:40例择期行斜视矫正术及白内障摘除术的患儿,随机均分为雷米芬太尼组(RF组)及芬太尼组(F组),分别以雷米芬太尼和芬太尼为TIVA的麻醉性镇痛药,观察两组诱导前(T0)、诱导时(T1)、气管插管时(T2)、手术开始时(T3)、手术开始后30min(T4)、拔管时(T5)的BP及HR的变化以及苏醒时的咽喉反射恢复时间,睁眼时间和拔管时间.结果:与T0时相比T1、T2和T4时RF组的SBP、DBP下降均比F组显著(P<0.05或P<0.01)在麻醉恢复期,RF组患者咽喉反射恢复时间、睁眼时间和拔管时间均显著短于F组(P<0.01).结论:与芬太尼相比,雷米芬太尼起效块,镇痛作用强,苏醒迅速,是更理想的全麻醉镇痛药.

Clinical contrast research of remifentanil and fentanyle in intravenous anesthesia in pedo-ophthalmologic operation

Objective:To investigate the effect of remifentanil and fentanyle in anesthesia induction,maintenance and analepsia in pedo-ophthalmologic operation.Methods:40 patients with orthopia or couching operation were randomized into the group RF(with the remifentanil as narcotic analgesic) and the group F(with the fentanyle as narcotic analgesic),the BP and HR before anesthesia induction(BP0,HR0),at anesthesia induction(BP1,HR1),at tracheal intubation(BP2,HR2),beginning operation(BP3,HR3),during operation 30min(BP4,HR4) and extubating(BP5,HR5),the recovery time of laryngeal reflex(T1),the time of eyes open(T2) and the time of extubating(T3) in two groups were observed respectively.Results:BP1,HR1,BP2,HR2,BP3,HR3,BP4,HR4 in group RF were significantly smaller than those in group F(P<0.05 or P<0.01).TI,T2,T3 in group RF were significantly smaller than those in group F(P<0.01).Conclusion:Compared with fentanyle,remifentanil is faster in becoming effective,stronger in analgesic effect,faster in analepsia,it is better than fentanyle in intravenous anesthesia.