瑞芬太尼复合丙泊酚静脉麻醉在小儿扁桃体摘除术中的应用

目的探讨瑞芬太尼复合丙泊酚静脉麻醉在小儿扁桃体摘除术中的应用效果。方法选择ASAⅠ～Ⅱ级、择期行扁桃体切除术的患儿80例,随机分为观察组和对照组,每组40例,观察组为瑞芬太尼复合丙泊酚麻醉组,对照组为常规芬太尼麻醉组,比较两组插管前后血流动力学变化、术后恢复和不良反应情况。结果两组插管前及插管后5min心率、血压无显著变化;插管后20min观察组心率低于对照组,差异具有显著性（P〈0.05）,但血压比较差异无统计学意义（P〉0.05）;插管后lh观察组心率、血压均低于对照组,差异有统计学意义（P〈0.05）,自主呼吸恢复时间、苏醒时间、清醒时间及停药至气管导管拔除时间均短于对照组,差异具有显著性（P〈0.05）。术后不良反应发生率观察组为27.5%,对照组为52.5%,两组比较差异有统计学意义（χ2=5.21,P〈0.05）。结论瑞芬太尼复合丙泊酚静脉麻醉能很好地满足小儿扁桃体摘除术的要求,麻醉深度可控性强,术中循环平稳,术毕苏醒迅速、完全,不良反应较少,是一种理想的小儿全身麻醉方法。

Application Analysis of Narcosis with the Complex of Remifentanil and Propofol in Surgical Excision of Tonsil in Children

Objective To discuss the narcosis effects of the complex of Remifentanil and Propofol in surgical excision of pediatric tonsil. Methods The ASA Ⅰ-Ⅱ was selected and 80 pediatric patients were divided into 2 groups; the observation group （ n = 40） and the control group （ n = 40）, all of whom underwent surgical excisions of tonsils. The observation group was narcotized with the complex of Remifentanil and Propofol, and the control group was narcotized with Fentanyl. The variety of hemodynamics, postoperative recovery and adverse reaction of both groups were analysed and compared. Results There was no significant change in HR and BP before intubatton and 5 min after intubatton. 20 minutes after intu- barton, the HR of observation group was lower than that of the control group （P 〈 O. 05 ）, but the BP of both groups showed no marked qualitative difference （P 〉 0. 05）. One hour after intubatton, the HR and BP of observation group were both lower than that of the control group with significant difference （ P 〈 0.05 ）. The recovery time of autonomous respiration, wake-up time, recovery time and time from drug withdrawal to tube drawing of trachea of observation group were all lower than that of the control group （P 〈 0. 05 ）. The adverse reaction of patient children in observation group was 27.5% , how- ever, that of the control group was 52.5%, higher than that of the observation group（P 〈 0. 05）. Conclusion The narcosis with the complex of Remifentanil and Propofol can meet the requirements of the operations, the narcosis deepness is of good controllability, intraoperative circulation is calm, postanaesthetie recovery is rapid, complete and has low adverse reaction. Therefore, the narcosis with the complex of Remifentanil and Propofol should be an ideal pediatric general anesthesia method.