摘要
目的观察舒芬太尼应用于小儿神经外科麻醉诱导期的血流动力学变化及术后恢复情况。方法 40例ASAⅠ或Ⅱ级、择期行脑积水手术的患儿,随机均分为舒芬太尼组(S组)和芬太尼组(F组)。麻醉诱导:两组分别给予等效剂量的舒芬太尼和芬太尼复合丙泊酚、维库溴铵;麻醉维持:瑞芬太尼持续微量泵静注复合七氟醚。术毕前10 min停七氟醚,同时两组分别给予等效剂量的舒芬太尼和芬太尼。观察两组麻醉诱导前即刻(T0)、气管插管前(T1)、气管插管后2 min(T2)、5min(T3)的血流动力学变化;记录术后患儿自主呼吸恢复时间、睁眼时间、拔管时间;记录拔管时(T4)、拔管后5 min(T5)、10 min(T6)的躁动(RS)评分、Ramsay镇静(RSS)评分。结果 T2、T3时F组MAP明显高于、HR明显快于T0时和S组(P<0.05)。两组苏醒期自主呼吸恢复时间、睁眼时间、拔管时间差异均无统计学意义;RS评分S组低于F组,RSS评分S组高于F组(P<0.05)。结论舒芬太尼在麻醉诱导期血流动力学更稳定,并可以有效预防小儿神经外科手术苏醒期的躁动,在小儿神经外科麻醉中具有很好的临床应用价值。
Objective To observe the change of hemodynamics and postoperative recovery in sufentanil induced pediatric neuroanesthesia. Methods Forty ASA Ⅰ or Ⅱ children for elective ventriculoscope surgery were randomly allocated to two groups： sufentanil group （group S） and fentanyl group （group F）. Group S was premedicated with sufentanil and group F was premedicated with equivalent dose fentanyl. Anesthesia was induced with propofol and vecuronium bromide. Maintenance of anesthesia consisted of continuous remifentanil infusion and sevoflurane inhalation. Sevoflurane was discontinued ten minutes before the end of operation. The change of hemodynamics was observed at the induction of anesthesia immediately （T0）, before tracheal cannula （T1）, 2 minute after intuhation （T2）, 5 minute after intubation （T3） ; Spontaneously breathing recovery time, eyes open time, extuhation time were recorded; RS and RSS score were calculated at extubation （T4）, 5 rain after extubation（T5 ）, 10 min after extubation （T6）. Results The change of hemodynamics in group F was significantly advanced as compared with group S （P〈0.05）. Spontaneously breathing recovery time, eyes open time, and extubation time of the two groups were not statistical significance： Group S had an lower RS score and higher RSS score compared with group F （P 〈 0.0,5）. Conclusion Sufentanil induced pediatric neuroanesthesia allows for maintaining a more stabile hemodynamics and lower incidence of restlessness compared with equivalent dose of fentanyl. There were commendable clinical application values of sufentanil in pediatric neurosurgery.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2011年第7期644-646,共3页
Journal of Clinical Anesthesiology
