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目的探讨瑞芬太尼静脉输注联合丙泊酚靶控输注在小儿短小手术麻醉中的应用效果。方法选取2010年1月—2014年1月于晋江市医院行短小手术患儿112例,随机分为对照组和观察组,各56例。对照组患儿予以七氟烷吸入麻醉,观察组患儿予以瑞芬太尼静脉输注联合丙泊酚靶控输注麻醉。观察两组患儿麻醉前(T0)、麻醉诱导结束(T1)、喉罩置入时(T2)、切皮时(T3)、切皮后(T4)、喉罩拔除时(T5)的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、血氧饱和度(Sp O2),观察两组患者停药后10、15min的清醒程度、苏醒时间、拔管时间、送返病房时间等麻醉效果指标及不良反应发生率。结果两组患儿T2~T4时间点的HR、RR、MAP比较,差异有统计学意义(P<0.05);T0~T5时间点的Sp O2比较,差异无统计学意义(P>0.05)。观察组患儿苏醒时间、拔管时间、送返病房时间短于对照组,差异有统计学意义(P<0.05);观察组停药后10min清醒程度高于对照组,差异有统计学意义(P<0.05);两组患儿15min清醒程度比较,差异无统计学意义(P>0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论瑞芬太尼静脉输注联合丙泊酚靶控输注应用于小儿短小手术麻醉中的效果显著,可稳定患儿血流动力学指标,加快患者清醒进程,缩短患者苏醒时间,且不良反应少,提高术后恢复质量。
Objective To investigate the effect of intravenous infusion of remifentanil combined with propofol target-controlled infusion in short-term anesthesia in children. Methods From January 2010 to January 2014, 112 children with short-term surgery in Jinjiang Hospital were randomly divided into control group and observation group, with 56 cases in each group. Control children were given sevoflurane inhalation anesthesia, the observation group were given remifentanil intravenous infusion of propofol target controlled infusion anesthesia. The heart rate before anesthesia (T0), anesthesia induction (T1), laryngeal mask placement (T2), skin incision (T3), skin incision (T4) and laryngeal mask removal (T5) (HR), respiratory rate (RR), mean arterial pressure (MAP) and oxygen saturation (Sp O2) were measured. The awakeness, recovery time and extubation time were observed at 10 and 15 minutes after stopping Time and other indicators of anesthesia and the incidence of adverse reactions. Results There was significant difference in HR, RR and MAP between T2 ~ T4 time point (P <0.05). There was no significant difference in Sp O2 between T0 ~ T5 (P> 0.05). The recovery time, extubation time and return ward time in the observation group were shorter than those in the control group (P <0.05). The observation group was more awake at 10 minutes after stopping the treatment than the control group (P <0.05), the difference was statistically significant P <0.05). There was no significant difference between the two groups in 15min awakening (P> 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion Intravenous infusion of remifentanil combined with propofol target-controlled infusion is effective in short-term anesthesia in pediatric patients, which can stabilize the hemodynamics of children, speed up the process of awake, shorten the recovery time of patients, and adverse reactions Less, improve the quality of postoperative recovery.