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目的评价不同浓度的瑞芬太尼靶控输注对婴幼儿气管插管反应的影响。方法选择45例行上腹部手术患儿,年龄1-3岁,随机分为3组(n=15),麻醉诱导开始时,分别靶控输注瑞芬太尼6ng/ml(Ⅰ组)、7ng/ml(Ⅱ组)、8ng/ml(Ⅲ组),10分钟后静脉注射异丙酚3mg/kg,意识消失后静脉注射维库溴铵0.1mg/kg,行气管插管,于输注瑞芬太尼前、气管插管前、气管插管即刻、气管插管后2、5、10min记录血压(BP)、心率(HR),并记录诱导过程中有无血压过低、心动过缓、肌肉强直、呛咳等不良反应的发生情况。结果诱导后3组SBP、DBP均降低,HR均减慢。Ⅰ组插管后即刻及插管后2minSPB、DBP和HR明显升高,而Ⅱ组、Ⅲ组未见明显升高;Ⅲ组插管后5min、10minSBP、HR明显降低。Ⅲ组血压过低、心动过缓、肌肉强直、呛咳等不良反应均明显高于Ⅰ组和Ⅱ组。结论婴幼儿瑞芬太尼靶控用于婴幼儿气管插管的靶控浓度为7ng/ml。
Objective To evaluate the effects of different concentrations of remifentanil target-controlled infusion on tracheal intubation in infants and young children. Methods Forty-five children undergoing abdominal surgery, aged 1-3 years old, were randomly divided into 3 groups (n = 15). At the beginning of anesthesia induction, remifentanil 6 ng / ml (Group Ⅱ), 8ng / ml (group Ⅲ). After 10 minutes, propofol 3mg / kg was intravenously injected. Vecuronium 0.1mg / kg was intravenously administered after disappearance of consciousness. After intubation, Remifentanil before tracheal intubation, endotracheal intubation immediately after tracheal intubation 2, 5, 10min recorded blood pressure (BP), heart rate (HR), and recorded during the induction of low blood pressure, bradycardia , Muscle rigidity, cough and other adverse reactions. Results After induction, the SBP and DBP in all three groups were decreased and HR decreased. The levels of SPB, DBP and HR in group Ⅰ were significantly increased immediately after intubation and 2 minutes after intubation, but not in group Ⅱ and Ⅲ. The levels of SBP and HR in group Ⅲ were significantly decreased at 5 and 10 minutes after intubation. Ⅲ group of low blood pressure, bradycardia, muscle rigidity, cough and other adverse reactions were significantly higher than Ⅰ and Ⅱ group. Conclusion The targeted control concentration of remifentanil in infants and young children was 7ng / ml.