摘要
目的比较瑞芬太尼和芬太尼用于小儿腭裂修复术麻醉的有效性和安全性。方法70例ASAI～Ⅱ级,1～5岁拟行腭裂修复术患儿随机分成瑞芬太尼组(R组)和芬太尼组(F组),每组各35例。麻醉诱导为异丙酚2.0mg/kg,瑞芬太尼1.5μg/kg或芬太尼2.0μg/kg,维持为吸入0.75%～1.0%七氟醚,泵入瑞芬太尼0.20μg/(kg·min)或芬太尼0.08μg/(kg·min)。比较两组麻醉各时段血流动力学变化和苏醒情况。结果R组在诱导后、插管、切皮各时间点MAP、HR均下降,与入室时比较差异有显著性(P<0.01,P<0.05),且插管时HR与F组比较差异有显著性(P<0.05);拔管时上升幅度大于F组(P<0.05),但R组苏醒快(P<0.05),拔管早,术后并发症少。结论瑞芬太尼可安全有效地用于小儿腭裂修复术的麻醉。
[Objective] To compare the clinical efficiacy and safety of remifentanil with that of fentanyl in pediatric patients undergoing palatorrhaphy under general anesthesia. [Methods] 70 ASAⅠ-Ⅱ pediatric patients aged 1- 5 years old undergoing palatorrhaphy were enrolled and randomized into remifentanil group （group R） and fentanyl group （group F）. Each group consisted of 35 cases. Anesthesia was induced with propofol （2.0 mg/kg）, plus either remifentanil （1.5 μg/kg） or fentanyl （2.0 μg/kg）, and maintained with inhalation of 0.75-1.0 vol% sevoflurane, plus a continous infusion of either remifentanil 0.20 μg/（kg·min） or fentanyl 0.08 μg/（kg·min）. The intraoperative hemodynamic parameters and recovery profile were compared. [Results] Hemodynamic values during induction, tracheal intubation and skin incision were significantly lower as compared with preoperative（P 〈0.01, P 〈0.05）. HR was significantly lower at tracheal intubation, and higher at tracheal extubation in group R than those in group F（P 〈0.05）. Quicker conscious recovery and less complications could be detected in group R in contrast with group F（P 〈0.05）. [Conclusions] Remifentanil-based general anesthesia presents more safety and efficacy than fentanyl-based anesthesia in pediatric patients undergoing palatorrhaphy.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第19期2372-2374,共3页
China Journal of Modern Medicine
