异丙酚瑞芬太尼和七氟烷瑞芬太尼用于小儿唇腭裂手术麻醉的临床观察.docVIP

异丙酚、瑞芬太尼和七氟烷、瑞芬太尼用于小儿唇腭裂手术麻醉的临床观察 　　作者：邓晓倩 王淼 吉阳 作者单位：(四川大学华西口腔医院 麻醉科，四川 成都 610041) 　　【摘要】 目的 比较异丙酚、瑞芬太尼和七氟烷、瑞芬太尼用于小儿唇腭裂手术麻醉的效果和安全性。方法 选择40例择期行唇腭裂修复术的患儿为研究对象，随机分为2组。PR组20例，采用异丙酚和瑞芬太尼麻醉;S组20例，采用七氟烷和瑞芬太尼麻醉。记录2组患儿在麻醉诱导前，麻醉诱导后15、30 min，拔管后1 min的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SPO2);并记录拔管时间、术后躁动分级，以及恶心呕吐和气道并发症的发生情况。结果 2组患儿的性别、年龄、体重、手术种类和手术时间的差异均无统计学意义(P0.05)。PR组在麻醉诱导后有2例患儿因心率较慢而使用阿托品，分别为3岁和8岁，前者心率低于100次/min，后者低于70次/min。与诱导前相比，PR组在拔管后1 min心率明显加快，S组在诱导后30 min和拔管后1 min心率明显加快(P0.05)。2组比较，S组的心率在诱导后15 min和30 min时较PR组快，其差异有统计学意义(P0.05)。术中2组的脉搏血氧饱和度均处于正常范围，无明显差异(P0.05)。2组的术后拔管时间没有统计学差异(P0.05)。PR组发生术后躁动者有2例，S组有8例，其差异有统计学意义(P0.05)。2组均未出现恶心呕吐，以及窒息、喉痉挛等气道并发症。结论 小儿唇腭裂手术采用异丙酚和瑞芬太尼麻醉时，对心率抑制较为明显;采用七氟烷麻醉时，术后躁动的发生率较高。2种麻醉方法都能较快达到拔管要求。 　　【关键词】 异丙酚; 瑞芬太尼; 七氟烷; 唇腭裂修复术 　　Clinical comparison of propofol and remifentanil anaesthesia with sevoflurane and remifentanil anaesthesia for children with cleft lip and palate repair surgery 　　DENG Xiao-qian, WANG Miao, JI Yang. 　　(Dept. of Anes-thesiology, West China College of Stomatology, Sichuan University, Chengdu 610041, China) 　　[Abstract] Objective To compare the clinical effects and safety of propofol and remifentanil anaesthesia with sevoflurane and remifentanil anaesthesia for cleft lip and palate repair surgery in children. Methods Forty children undergoing elective cleft lip and palate repair surgery were randomly divided into two groups, 20 in each group. Group PR: Propofol and remifentanil anaesthesia; and group S: Sevoflurane and remifentanil anaesthesia. Heart rate (HR), mean arterial pressure(MAP), pulse oxygen saturation(SPO2), and end tidal carbon dioxide(ETCO2) were ob-served, and recorded at the time before the induction(T0), after 15 min of induction(T1), after 30 min of in-duction(T2), and after 1 min of extubation(T3). The time to extubation, incidence of restlessness, postoperative nausea andvomiting, and the complication of the airway were recorded. Results There were no significantly differences between the t