瑞芬太尼用于小儿先天性唇腭裂修复术麻醉观察.docVIP

瑞芬太尼用于小儿先天性唇腭裂修复术麻醉观察[摘要]目的：观察瑞芬太尼用于小儿先天性唇腭裂修复术麻醉时的血流动力学变化、苏醒时间和苏醒质量。 方法：选择先天性唇腭裂修复术小儿30例，随机分成瑞芬太尼组（R组，n=15）和芬太尼组 (F组,n=15)。麻醉诱导R组用瑞芬太尼1～2μg/kg，F组用芬太尼2～3μg/Kg，插管后行机械通气，R组持续输注瑞芬太尼0.2～0.25μg.Kg-1.min-1，F组每隔15～20min缓慢静注芬太尼1μg/Kg。两组均持续吸入1%异氟烷。监测指标包括患者诱导前、诱导后2min、气管插管后2min、手术开始后10min的血流动力学变化，连续记录有创动脉压力（IBP）、心率（HR）、血氧饱和度（SPO2）。术毕停药后患者自主呼吸恢复时间、睁眼时间、拔管时间及躁动情况。 结果：两组诱导后血压、心率均降低，无显著性差异（P＞0.05）。R组插管后血流动力学平稳，而F组插管后2min血压升高、心率加快（P＜0.05）。手术开始后10min,R组血压、心率低于F组（P＜0.05）。两组患儿自主呼吸恢复时间、睁眼时间、拔管时间R组少于F组（P＜0.05）。躁动R组多于F组，两组比较有显著性差异（P＜0.05）。 结论：瑞芬太尼复合异氟烷麻醉用于小儿先天性唇腭裂修复术可使血流动力学稳定、苏醒迅速、并发症少，是一种安全、有效的麻醉方法。 [关键词]瑞芬太尼；芬太尼；小儿；先天性唇腭裂 [中图分类号]R622 [文献标识码]A [文章编号]1008（6455）08-1231-03 Clinical observation of remifentanil in anesthesia for children’s primary cleft of lip or palate repair RAN Hong,WANG Rui (Department of Anesthesiology Xi’an Centre Hospital,Xi’an 710003,Shaanxi,China) Abstract:ObjectiveTo observe the hemodynamic variation, time and quality for recurrence. Methods Thirty children undergoing primary of lip or palate repair were randomly divided into remifentannil group(R group, n=15) or fentanyl group(F group, n=15).Drugs for induction were remifentanil 1～2μg/Kg in R group or fentanyl 2～3μg/Kg in F group. Anesthesia was maintained by isoflurane, and in R group, 0.2～0.25μg.kg-1.min-1 remifentanil was infused；in F group, 1μg/kg fentanyl was infused every15～20min.IBP,HR and SPO2before induction, after induction, after intubation 2 min, 10min after starting operation were recorded.The time leths of ceasing drugs to restoration of automatic respiration,openning eyes, from ceasing of drugs to evulsed tracheal pipe and quality for recurrence were also recorded. Results There were no significant difference among the results of IBP and HR （P＞0.05）after induction of anesthesia.The hemodynamic changes were stable in R group. Blood pressure was higher and HR increased after intubation 2 min in F group（P＜0.05）.Compared with F group,IBP and HR of 10min after starting operation were l