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目的:探讨瑞芬太尼复合丙泊酚与氯胺酮复合丙泊酚在小儿纤维结肠镜检手术的临床应用。方法:肠镜检查手术患儿100例,随机分为氯胺酮复合丙泊酚组(K组50例)和瑞芬太尼复合丙泊酚组(R组50例)。K组给予氯胺酮2 mg/kg和丙泊酚2 mg/kg,R组给予瑞芬太尼0.5μg/kg和丙泊酚2 mg/kg,面罩吸氧,术中有肢动追加丙泊酚1～2 mg/kg。观察患儿心率(HR)、呼吸频率(RR)、氧饱和度(SpO2)变化,观察术后苏醒时间、离院时间及不良反应的发生情况。结果:两组患儿HR、RR、SpO2比较差异无统计学意义(P>0.05);R组患儿术后意识恢复时间、离院时间短于K组,K组患儿苏醒期有12例出现精神症状,两组比较差异均有统计学意义(P<0.05)。结论:瑞芬太尼复合丙泊酚应用于小儿纤维结肠镜检手术效果优于氯胺酮复合丙泊酚,满足手术要求,无不良反应发生,安全可行。
Objective: To investigate the clinical application of remifentanil combined with propofol and ketamine combined with propofol in pediatric colonoscopy. Methods: 100 cases of children underwent colonoscopy were randomly divided into ketamine combined propofol group (50 cases in K group) and remifentanil combined with propofol group (50 cases in R group). K group was given ketamine 2 mg / kg and propofol 2 mg / kg, R group was given remifentanil 0.5μg / kg and propofol 2 mg / kg, oxygen mask, intraoperative limbs with additional propofol 1 ~ 2 mg / kg. The changes of heart rate (HR), respiratory rate (RR) and oxygen saturation (SpO2) in children were observed. The recovery time, the time of leaving hospital and the adverse reaction were observed. Results: There was no significant difference in HR, RR and SpO2 between the two groups (P> 0.05). The recovery time and departure time of children in group R were shorter than those in group K Psychiatric symptoms, the difference between the two groups were statistically significant (P <0.05). CONCLUSION: Remifentanil combined with propofol is superior to ketamine combined with propofol in colonoscopy of pediatric patients. It meets the surgical requirements without any adverse reactions and is safe and feasible.