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目的观察丙泊酚复合瑞芬太尼静脉麻醉用于小儿扁桃体摘除术的效果。方法将小儿扁桃体摘除术50例,随机分为芬太尼组及瑞芬太尼两组,每组25例。瑞芬太尼组缓慢静注0.1mg/kg咪唑安定、0.10mg/kg万可松、1.5mg/kg丙泊酚,1μg/kg瑞芬太尼,经口明视气管插管,机械通气。输注瑞芬太尼0.05～0.20μg/(kg·min)、丙泊酚0.25～0.5μg/(kg·min)维持麻醉。芬太尼组以静注咪唑安定、万可松、丙泊酚,3～4μg/kg芬太尼麻醉诱导、插管,以0.25～0.5μg/(kg·min)丙泊酚、间断注射芬太尼维持麻醉。患儿自主呼吸恢复、神智清醒后拔管。结果两组患儿性别、年龄、体重、手术时间相比差异无统计学意义;两组病例麻醉效果满意,心率(HR)、血压(BP)、心电图(ECG)、PETCO2、血氧饱和度(SPO2)均正常,均未发生手术及麻醉并发症;瑞芬太尼组吞咽恢复时间、睁眼时间、拔除气管导管时间明显小于芬太尼组(P<0.05)。结论丙泊酚复合瑞芬太尼静脉麻醉应用于小儿扁桃体摘除手术,与丙泊酚、芬太尼静脉麻醉比较,具有诱导迅速、麻醉平稳、术后清醒快,并发症少等优点,是较为理想的麻醉方法。
Objective To observe the effect of propofol combined with remifentanil intravenous anesthesia on pediatric tonsillectomy. Methods 50 children with tonsillectomy were randomly divided into fentanyl group and remifentanil two groups, 25 cases in each group. Remifentanil group was slowly intravenously injected with 0.1 mg / kg midazolam, 0.10 mg / kg vancomycin, 1.5 mg / kg propofol, and 1 μg / kg remifentanil. Remifentanil was infused 0.05 ~ 0.20μg / (kg · min) and propofol 0.25 ~ 0.5μg / (kg · min) to maintain anesthesia. The fentanyl group was given anesthesia induced by midazolam, wancomon, propofol, fentanyl 3-4μg / kg, intubation, and propofol 0.25-0.5μg / (kg · min) Tai Nai maintain anesthesia. Children with spontaneous breathing recovery, sober mind extubation. Results There was no significant difference in sex, age, body weight and operation time between the two groups. The anesthesia effect was satisfactory in both groups. HR, BP, ECG, PETCO2, oxygen saturation SPO2) were normal, no complications of surgery and anesthesia occurred. The recovery time, eye opening time and tracheal extubation in remifentanil group were significantly shorter than those in fentanyl group (P <0.05). Conclusion Intravenous anesthesia with propofol combined with remifentanil is suitable for tonsillectomy in children. Compared with intravenous anesthesia with propofol and fentanyl, propofol combined with remifentanil has the advantages of prompt induction, stable anesthesia, quick wakefulness after surgery and few complications. Ideal anesthetic method.