相同靶浓度不同容量的瑞芬太尼联合腹横肌平面阻滞在小儿腹腔镜手术中的应用.docxVIP

相同靶浓度不同容量的瑞芬太尼联合腹横肌平面阻滞在小儿腹腔镜手术中的应用 临沂市沂水屮心医院麻醉科山东临沂276400 摘要：目的：观察相同血浆浓度不同容量的瑞芬太尼用于小儿腹腔镜手术患者的 麻醉效果。方法：选取小儿腹腔镜手术180例患者，因麻醉维持药物浓度差异将 其分成A组60例(瑞芬太尼20ug/mL进行麻醉维持)，B组60例(给予10ug/m L瑞芬太尼进行麻醉维持)，C组60例(给予5ug/m L瑞芬太尼进行麻醉维持)。 记录3组患儿不同时刻心率、血压，记录手术时间，患儿苏醒时间，患儿在PACU 停留时间，手术麻醉过程屮发生的不良事件。结果A组患儿MAP和心率均有一 定程度的下降(PIt; 0.05), C组患儿MAP和心率均有不同程度的上州Plt; 0.05), B、C组与A组比较患儿苏醒时间短(P lt; 0.05),患儿在PACU停留时间短(P lt; 0.05)； B组与A、C组比较患儿苏醒期不良事件发生率低(PIt; 0.05)o结论 10ug/mL瑞芬太尼靶控输注联合腹横肌平面阻滞用于小儿腹腔镜手术患者麻醉 效果好，苏醒快，值得推广。 关键词：靶控输注；腹横肌平面；小儿；腹腔镜手术 [Absract] Objective To observe the effect of the same target concentration about d iff ere nt capacity of remife ntanyl combi ned with tra nsverse abdominal plane (TAP) block anesthesia applying to pediatric laparoscopic surgery. Methods 180 case of children schduled for elective inguinal hernia repair were randomly divided into three groups due to the concerntration differenee (group A group B and group C each group has 60 cases).Group A: Remifentanyl 20 ug/mL to maintain anesthesia;group B: Remifentanyl 10 ug/mL to maintain anesthesia; group C: Remifentanyl 5 ug/mL to maintain anesthesia. The HR and blood pressure of different time, the operation time, awake time, staying period in PACU, adverse events during general anesthesia were recorded. Results the blood pressure and heat rate decreased to some extent of the children in group A( P lt; 0.05), in group C childre nrsquo;s blood pressure and heat rate in creased in differe nt degrees ( P lt; 0.05), Result group B and C compared with group A awake time was shorter( P lt; 0.05), staying period in PACU was shorter( P lt; 0.05), adverse events were also less likely to occur in anesthesia recovery period ( P lt; 0.05). Conculusion 10 ug/mL remife ntanyl target con trolled inf usio n joint abdomi nal tran sverse plane block used for pediatric patients with laparoscopic surgery anesthesia effect was good, with rapid recovery, was worth promoting? 【中图分类号】R473.2【文献标识码】A【文章编号】1001-5213(2016)09-0017-02 随着腔镜技术在外科领域的发展，小儿腹腔镜