摘要
目的探讨瑞芬太尼-丙泊酚麻醉在小儿气管异物取出术中的麻醉效果及安全性。方法选择满足美国麻醉医师协会制定的ASA分级Ⅰ~Ⅱ级标准、年龄2~5岁、行气管异物取出术患儿40例,分为瑞芬太尼-丙泊酚麻醉组(A组)和r-羟基丁酸钠.氯胺酮麻醉组(B组)各20例。记录诱导前(T0)、插支气管镜后(T1)、拔支气管镜时(T2)、清醒时(T3)各时点的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO2)、并发症及苏醒时间。结果两组T1与T2时DBP差异无显著性意义(P〉0.05),其他血流动力学指标变化差异均有显著性意义(P〈0.05);A组患儿术中血流动力学相对平稳,B组患儿血流动力学变化较大;A组患儿术中置镜后喉痉挛、屏气、呛咳的发生率均较B组少,苏醒时间较B组短(P〈0.05)。结论瑞芬太尼-丙泊酚麻醉可安全有效地用于小儿气管异物取出术,并具有血流动力学稳定、术中及术后并发症少、患儿苏醒迅速和苏醒质量高的优点。
Objective To study the clinical efficacy and safety of remifentanil-propofol anesthesia in tracheal foreign body removal. Methods Forty patients aged from 2 to 5 years old and admitted for tracheal foreign body, ASA Ⅰ - Ⅱ , were randomly divided into two groups, group A ( n = 20 ) and group B ( n = 20 ). Group A was anesthetized by using remifentanil and propofol, while group B by sodium hydroxybutyrate and ketamine. SBP.DBP.HR and SpO2 were monitored in both groups before operation and at the time point of bronchial endoscopy, endoscope removial ,consciousness recovery. The post-operative complications and recovery time were recorded. Results Except for the diastolic blood pressure, other hemodynamic parameters at T and Tshowed significant difference between the two groups ( P 〈 0. 05 ). There were less circulatory fluctuation, faster recovery with lower incidence of post-operative complications in group A than in group B ( P 〈 0. 05 ). Conclusions Remifentanil combined with propofol can be used safely and effectively in the anesthesia of children undergoing tracheal foreign body removal
出处
《实用医院临床杂志》
2009年第5期66-68,共3页
Practical Journal of Clinical Medicine
关键词
瑞芬太尼
小儿
气管异物
Remifentanil
Children
Tracheal foreign body