论文部分内容阅读
目的探讨小儿扁桃体切除术毕前应用芬太尼对瑞芬太尼复合丙泊酚麻醉镇痛的效果。方法 30例患儿实施小儿扁桃体切除术随机均分成Fl、F2和N组,术毕前分别给予F1,F2组芬太尼1μg/kg,2μg/kg,N组为对照组,评定拔管后疼痛和镇静程度,记录呼吸恢复、意识恢复和拔管时间以及拔管后的不良事件,连续监测MAP和HR。结果 F1和F2组的VAS评分较N组显著降低(P<0.01),两组Ramsay评分显著高于N组(P<0.01),且F2较F1显著增高(P<0.05)。F2组的呼吸恢复、意识恢复和拔管时间与F1和N组相比均明显延长(P<0.01)。N组的MAP和HR在恢复过程中逐渐升高,而F1和F2组的MAP和HR变化相对较平稳。结论在小儿扁桃体切除术结束前应用1μg/kg芬太尼可减轻瑞芬太尼停药后的疼痛反应,但不显著延迟苏醒和拔管时间。
Objective To investigate the effect of fentanyl on remifentanil combined with propofol anesthesia before pediatric tonsillectomy. Methods Thirty children undergoing tonsillectomy were randomly divided into two groups: F1, F2 and N. Fentanyl (1μg / kg, 2μg / kg) was administered to F1 and F2 groups before operation. N group was used as control group. After extubation Pain and sedation, respiratory resuscitation, consciousness recovery and extubation time, as well as extubation adverse events, continuous monitoring of MAP and HR. Results The VAS scores of F1 and F2 group were significantly lower than those of N group (P <0.01). The Ramsay scores of the two groups were significantly higher than those of N group (P <0.01), and F2 was significantly higher than F1 (P <0.05). Respiratory recovery, consciousness recovery and extubation time in F2 group were significantly longer than those in F1 and N groups (P <0.01). The MAP and HR of N group increased gradually during the recovery, while the changes of MAP and HR of F1 and F2 group were relatively stable. Conclusions The use of 1 μg / kg fentanyl at the end of pediatric tonsillectomy may reduce the pain response after remifentanil discontinuation without significantly delay the recovery and extubation time.