瑞芬太尼静脉麻醉在小儿鼾症手术中临床观察.docVIP

瑞芬太尼静脉麻醉在小儿鼾症手术中临床观察(安徽省宿州市第一人民医院麻醉科 安徽 宿州 234000)?? 【摘要】 目的;比较瑞芬太尼与芬太尼复合丙泊酚静脉麻醉在小儿扁桃体、腺样体切除术麻醉效果。方法 选择ASAI～Ⅱ级，年龄4～10岁，择期在丙泊酚复合静脉麻醉下的扁桃体、腺样体切除术患儿40例，随机分为观察组(瑞芬太尼组)和对照组(芬太尼组)，每组20例，分别以瑞芬太尼静脉泵注、芬太尼静脉注射诱导及维持麻醉，连续观察入室至麻醉期间的血流动力学变化、记录停药后自主呼吸恢复时间、苏醒时间及气管拔管时间，观察患儿拔管后上呼吸道梗阻或屏气的发生率、苏醒期躁动、术后恶心、呕吐的发生率。结果 观察组患儿手术后苏醒迅速，苏醒期并发症发生率低。结论 与芬太尼比较，瑞芬太尼具有术中循环稳定，术后苏醒迅速，并发症少的特点。? 【关键词】 瑞芬太尼 芬太尼 扁桃体 腺样体 静脉麻醉? 【中图分类号】 R971 【文献标识码】 A【文章编号】1044-5511(2011)09-0159-02?? 【Abstract 】 objective: More Remyfentanyl and fentanyl tabor phenolic compound c intravenous anesthesia in children tonsil, adenoidectomy anesthesia effect. Method Choose ASAI ~ Ⅱ level, Age 4 ~ 10 years old. In c phenolic compound Propofol elective under intravenous anesthesia tonsils, adenoidectomy 40 cases children, Were randomly divided into trial group(Remyfentanyl group) And the control group(fentanyl group), Each group of 20 cases, Respectively by Remyfentanyl vein pump injection、Fentanyl intravenous induction and maintenance of anesthesia Continuous observation enter indoor to hemodynamic changes during anesthesia, Record after discontinuation of spontaneous breathing recovery time、Round time and Tracheal decannulation time, Observe the upper respiratory tract obstruction after children drawing tube or breathless incidence, Awakening period restless, The incidence of postoperative nausea and vomiting. reults The observation group of children of the awakening to wake up rapidly after the operation of complication rate low. verdict Compared with fentanyl, Remyfentanyl have operation in circulation stabilization, postoperative came quickly, the characteristics of few complications.? 【key words】 Remifentanil fentanyl tonsil Adenoid intravenous anesthesia?? 小儿鼾症以儿童扁桃体肥大伴腺样体增生多见，以手术切除扁桃体和腺样体为主要治疗方式。此类手术时间短，咽喉部刺激较强，术后要求完全苏醒。近年来多选择气管插管静吸复合全麻，但苏醒时间长，术后易烦躁，并发症较多。瑞芬太尼是新型的μ-阿片受体激动剂，药效强、起效迅速、代谢清除快，在小儿麻醉中的应用少见报道[1]。本文观察瑞芬太尼用于小儿麻醉的可行性、安全性及临床效果。 ? l资料与方法? 1．1一般资料：择期行扁桃体、腺样体切除术患儿40例，ASAI～Ⅱ级，年龄4～10岁，体重14―30 kg。随机分为