瑞芬太尼复合七氟醚联合喉罩麻醉在小儿眼科手术中的应用.docVIP

HYPERLINK /Periodical_zgyydk200704024.aspx \t _blank 瑞芬太尼复合七氟醚联合喉罩麻醉在小儿眼科手术中的应用 [摘要］目的 探讨瑞芬太尼复合七氟醚联合喉罩麻醉在小儿眼科手术中的应用。方法 选取拟行眼科手术患儿48例，随机分为七氟醚复合瑞芬太尼组（SR组）和传统的异丙酚复合瑞芬太尼组（PR组）各24例。监测两组患儿血流动力学变化，记录术后恢复情况。结果 SR组血流动力学较PR组更稳定(P0.05)，术中及术后发生并发症少，与PR组相比，差异具有统计学意义(P0.05)，SR组恢复自主呼吸时间、拔除喉罩时间及恢复意识时间均快于PR组(P0.05)。结论 瑞芬太尼复合七氟醚联合喉罩麻醉，操作简单且安全有效，对气道刺激小，血流动力学稳定，术后并发症少，苏醒迅速且彻底，可在小儿眼科手术中推广应用。 [关键词] 小儿眼科手术；瑞芬太尼；七氟醚；喉罩 Application of Laryngeal mask airway combined with Remifentanil and Sevoflurane anesthesia in pediatric ophthalmic surgery [Abstract] Objective To investigate the anesthesia effect of laryngeal mask combined with remifentanil and sevoflurane in pediatric ophthalmic surgery. Methods 48 children undergoing ophthalmic surgery were randomly divided into SR group (sevoflurane-remifentanil group) and PR group (propofol-remifentanil group), each 24 cases. Hemodynamic changes was detected during the operation. Results The hemodynamics of SR group were more stable than PR group (P0.05). The intraoperative and postoperative complication rate of the SR group was significantly higher than PR group(P0.05). The time of freedom breath, goggle and evulsion cannulation in SR group were faster than PR group (P0.05).Conclusion In pediatric ophthalmic surgery，application of laryngeal mask airway combined with remifentanil and sevoflurane anesthesia was safe, effective and hemodynamic stability, less postoperative complications, recovery quickly and thoroughly. [Key words] pediatric ophthalmic surgery; remifentanil; sevoflurane; laryngeal mask airway 喉罩对气道刺激小，可减轻气管插管所引起的声音嘶哑和喉头水肿[1]，有利于呼吸道管理，适合小儿眼科手术中运用[2]。本研究旨在探讨瑞芬太尼复合七氟醚联合喉罩麻醉在小儿眼科手术中的应用，为小儿眼科手术提供一个安全稳定可靠的麻醉方法。 1 资料与方法 1.1 一般资料 选取2010年6月-12月拟在我院行眼科手术患儿48例，ASAⅠ级或Ⅱ级，男28例，女20例，年龄3-10岁，体质量15-32kg。既往无其他系统疾病。无麻醉禁忌证。随机将患儿分为瑞芬太尼联合七氟醚组（SR组）与传统的瑞芬太尼联合异丙酚组（PR组），各24例。两组年龄、性别、体重比较差异无统计学意义(P0.05)。 1.2 麻醉方法： 在麻醉前肌注阿托品0.02 mg/kg，建立静脉通道，常规监测收缩压(SBP)、舒张压(DBP)、心率（HR）和脉搏血氧饱和（SpO2）。两组均静注瑞芬太尼1 μg/kg和异丙酚2 mg/kg行麻醉诱导同时面罩吸氧。喉罩在患儿睫毛反射消失时置入。接麻醉机通气，微量泵静脉维持麻醉，SR组给予瑞芬太尼3