摘要
目的:观察不同剂量瑞芬太尼复合丙泊酚用于儿童气管插管术的麻醉效果和安全性。方法:120例拟行气管插管术患儿随机分为A组(40例)、B组(40例)和C组(40例)。所有患儿术前禁食禁水6 h,术前0.5 h肌内注射阿托品0.02 mg/kg,开通静脉补液通道,监护心电后,1 min内缓慢肌内注射丙泊酚2 mg/kg+瑞芬太尼2μg/kg+维库溴铵0.1 mg/kg+地塞米松2 mg。之后,A组患儿微静脉泵持续注入瑞芬太尼0.1μg/(kg·min)+丙泊酚5 mg/(kg·h);B组患儿微静脉泵持续注入瑞芬太尼0.2μg/(kg·min)+丙泊酚5 mg/(kg·h);C组患儿微静脉泵持续注入瑞芬太尼0.3μg/(kg·min)+丙泊酚5 mg/(kg·h)。观察各组患儿不同时间点的心率、平均动脉压,瑞芬太尼使用量、丙泊酚使用量、术后恢复自主呼吸时间、拔管时间及不良反应发生情况。结果:各组患儿不同时间点的心率、平均动脉压比较,差异均无统计学意义(P>0.05)。丙泊酚使用量、术后恢复自主呼吸时间、拔管时间、不良反应发生率C组<B组<A组,瑞芬太尼使用量C组>B组>A组,差异均有统计学意义(P<0.05)。结论:不同剂量瑞芬太尼复合丙泊酚对气管插管术患儿的心率、动脉压影响均较小,而0.3μg/(kg·min)瑞芬太尼复合丙泊酚时的术后恢复情况和安全性均较好。
OBJECTIVE： To explore the anesthetic effects of remifentanil of different doses combined with propofol for tracheal intubation in children. METHODS： 120 children scheduled for tracheal intubation were randomly divided into group A （40 cases）, group B （40 cases） and group C （40 cases）. All children forbid food and water 6 h before surgery, intramuscularly injected 0.02 mg/kg atropine 0.5 h before surgery, intravenous access opening, ECG monitoring, then slowly injected propofol 2 mg/kg＋ remifentanil 2 μg/kg＋vecuronium 0.1 mg/kg＋dexamethasone 2 mg within 1 min ; group A continuously infused remffentanil 0.1 lag/（kg·min ） ＋propofol 5mg/（kg.h） by microvascular pump; group B continuously infused remifentanil 0.2 lag/（kg .min）＋propofol 5mg/（kg.h） by microvascular pump; group C continuously infused remifentanil 0.3 μg/（kg. min）＋propofol 5mg/（kg. h） by microvascular pump. Heart rate and mean arterial pressure at different time points, use amount of remifentanil and propofol, postoperative recovery time to spontaneous breathing, extubation time, and the incidence of adverse reactions in all groups were observed. RESULTS： There were no significant differences in the heart rate and mean arterial pressure at different time points in each group （P〉0.05）. Use amount of propofol, postoperative recovery time to spontaneous breathing, extubation time and the incidence of adverse reactions in group C were significantly lower than group B, which were lower than group A, the use amount of remifentanil in group C was higher than group B, which was higher than group A, with statistical significances （P〈0.05）. CONCLUSIONS： Remifentanil of different doses combined with propofol has small effects on heart rate and arterial pressure for children in tracheal intubation, while 0.3μg/（kg.min） remifentanil combined with propofol shows good postoperative recovery and safety.
出处
《中国药房》
CAS
北大核心
2016年第36期5088-5090,共3页
China Pharmacy
关键词
不同剂量
瑞芬太尼
丙泊酚
儿童
气管插管术
麻醉效果
安全性
Different doses
Remifentanil
Propofol
Children
Tracheal intubation
Anesthetic effect
Safety
