摘要
目的观察丙泊酚-瑞芬太尼在小儿扁桃体切除术中的应用效果. 方法 30例ASAⅠ级患儿,肌注氯胺酮5mg/kg入睡后,随机分为两组:瑞芬太尼组(R组,n=15)麻醉诱导以咪唑安定0.1 mg/kg,瑞芬太尼1.0 μg/kg,丙泊酚1.0 mg/kg,卡肌宁0.5 mg/kg静注,气管插管后行机控呼吸,维持以丙泊酚4 .0～9 .0 mg/(kg·h), 瑞芬太尼0.5 μg/(kg·min)静脉泵注;常规芬太尼组(F组, n=15)麻醉诱导以咪唑安定0 .1 mg/kg, 芬太尼5.0 μg/kg,卡肌宁0.5 mg/kg静注,以1%～2%异氟醚维持麻醉.观察并记录麻醉前、插管时、术中及拔管时血压、心率的变化以及手术后苏醒时间、苏醒期呼吸抑制、喉痉挛、呕吐、躁动等不良反应. 结果 R组病人术中循环波动小,苏醒迅速,术后并发症少.结论丙泊酚-瑞芬太尼的联合应用能安全有效地应用于小儿扁桃体切除术.
Objective To investigate the application of Propofol-Remifentanil in tonsillectomy of child. Methods 30 children of ASA I were anesthetized with Ketamine 5.0 mg/kg im. Cases in Remifentanil group（ Group R, n = 15 ） were intravenous induced with Midazolam 0. 1 mg/kg, Remifentanil 1.0μg/kg, Propofol 1.0 mg/kg, and Traerium 0. 5 mg/kg, and intubated for controlled respiration, and maintain with Propofol 4.0 - 9.0mg/（ kg· h） , and Remifentanil 0.5 μg/（ kg ·min）. Cases in Fentanyl group （ Group F, n = 15） were intravenous induced with Midazolam 0.1 mg/kg, Fentanyl 5.0 μg/kg, Tracrium 0.5mg/kg, and maintain with 1% -2% Isoflurance. BP and HR were observed and recorded at the time point of before anesthesia, endotracheal intubation, during the operation and decannulation and awaking duration, respiratory decompression, laryngospasmus, vomiting, restlessness were recorded as well. Result Cases in group R had a more stable hemodynamic condition, faster awaking duration and less postoperative complication in contrast with group F. Conclusion The application of Propofol-Remifentanil in tonsillectomy of child is recommendable.
出处
《中国现代手术学杂志》
2005年第5期377-379,共3页
Chinese Journal of Modern Operative Surgery
