不同药物配伍用于小儿头颈部手术麻醉的效果比较

目的：比较氯胺酮、七氟烷、舒芬太尼、瑞芬太尼和丙泊酚用于小儿头颈部手术麻醉的血流动力学变化及苏醒质量.方法：选择择期头颈手术小儿100例,随机分为氯胺酮组（A组）、氯胺酮联合瑞芬太尼组（B组）、七氟烷组（C组）、舒芬太尼联合丙泊酚组（D组）、瑞芬太尼联合丙泊酚组（E组）,各20例.记录插管前、插管时、术中10布min、手术结束时和清醒拔管时的平均动脉压、心率,观察手术结束至患儿的自主呼吸恢复时间、睁眼时间、拔管时间及拔管后躁动情况.结果：插管时和清醒拔管时的平均动脉压和心率,C、D、E组均低于A组（P〈0.05～P〈0.01）,术毕自主呼吸恢复时间、睁眼时间、苏醒拔管时间B、C、E组均短于A组（P〈0.01）.结论：与氯胺酮比较,瑞芬太尼、舒芬太尼用于小儿手术的麻醉更有利于稳定血流动力学和缩短苏醒时间,舒适度高.

The anesthesia effect comparison of different anesthetic drugs in head and neck surgery of children

Objective： To compare the effects of ketamine, sevoflurane, sufentanil, remifentanil and propofol on the hemodynamic change and awakening quality during the anesthesia of head and neck surgery in children. Methods： One hundred children with elective head and neck surgery were randomly divided into ketamine group （group A）, ketamine remifentanil group （group B ）, sevoflurane group （group C）,sufentanil propofol group（ group D） and remifentanil propofol group（ group E）（20 cases each group）. The mean arterial blood pressure and heart rate of all groups were measured before intubation, during intubation, 10 minutes of surgery, the end of operation and during extubation. The recovery time of spontaneous breathing, eye opening time, extubation time and agitation after extubation were observed after operation. Results ：The mean arterial blood pressure and heart rate in group C, D and E were lower than those in group A during intubation and extubation（ P 〈 0.01 ）. The recovery time of spontaneous breathing, eye opening time and extubation time in group B, C and E were shorter than that in group A after operation（ P 〈 0.05 to P 〈 0.01 ）. Conclusions：Compared with ketamine, remifentanil and sufentanil are beneficial to stabilize hemodynamics, short the awakening time and improve the comfort level during children＇s anesthesia.