摘要
目的探讨瑞芬太尼、芬太尼对小儿扁桃体切除术中应激和苏醒期躁动的影响。方法 85例行扁桃体切除手术患儿分为瑞芬太尼合用异丙酚组(A组,40例)和芬太尼合用异丙酚组(B组,45例),比较两组患儿4个时间点的血流动力学、血糖及皮质醇的变化及术后苏醒期躁动。结果①与T0相比,A组T1、T2时点MAP降低(P<0.05),B组T2时点MAP升高(P<0.05);T1、T2时点B组MAP高于A组。②与T0相比,A组T1、T2时点HR降低(P<0.05),B组T2、T3时点HR升高(P<0.05);T1、T2及T3时点B组HR高于A组(P<0.05)。③与T0相比,A组T1,T2和T3时点皮质醇下降,B组T1时皮质醇升高(P<0.05),T3时点皮质醇下降(P<0.05);T1、T2时点B组皮质醇高于A组(P<0.05),T3时点B组皮质醇低于A组(P<0.05)。④术后观察A组患儿苏醒快于B组(P<0.05)。结论瑞芬太尼、异丙酚复合全凭静脉麻醉能更好地稳定患儿的血流动力学改变,术后苏醒时间短,能更适合于小儿扁桃体切除手术。
Objective To investigate the effects of remiefntanil and fentanyl on the stimulation and restlessness of pediatric tonsillectomy. Methods A total of 85 pediatric patients were randomly divided into 2 groups： group A （remifentanil and propofol total intravenous anesthesia,40 cases）,group B （fentanyl and propofoltotal intravenous anesthesia, 45 cases）. The cervical venous blood samples were obtained at four time points. The duration and the charaeteristies of postoperative re- covery were investigated between two group. Results （1）MAP at T1 and T2 in group A were significantly lower than that at TO （P 〈 0.05）, MAP at T2 in group B were significantly higher than that at T0（P 〈 0.05）. MAP in group B were signif- icantly higher than those in group A at T1 and T2（P 〈 0.05）. （2）HR at T1 and T2 in group A were significantly lower than that at TO （P 〈 0.05）, HR at T2 and T3 in group B were significantly higher than that at TO（P 〈 0.05）. At T2 and T3,HR in group B were significantly higher than those in group A（P 〈 0.05）. （3）The level of cortisol at TI,T2 and T3 in group A were significantly lower than that at TO （P 〈 0.05）, the level of eortisol at T1 in group B was significantly higher than that at TO （P 〈 0.05）. At T3 the level of cortisol was significantly lower than that at TO （P 〈 0.05）. The level of cortisol in B groups at TI and T2 were significantly higher than those in A group （P 〈 0.05）. The levels of cortisol in B groups at T3 was significantly lower than that in A group（P 〈 0.05）. （4）The duration of postoperative recovery in A group was shorter than that in B group. Conclusion Remiefntanil and propofol total intravenous anesthesia may reduce the stress reaction, better hemodynamic stability and recovery profile. It＇s a better method for pediatric tonsillectomy.
出处
《中国现代医生》
2012年第29期88-90,共3页
China Modern Doctor
