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目的探讨舒芬太尼用于婴幼儿唇腭裂修复术的可行性。方法 60例婴幼儿唇腭裂修复术患儿随机分为两组:舒芬太尼组(Ⅰ组),芬太尼组(Ⅱ组),每组30例。Ⅰ组诱导方法:芬太尼4μg/kg,丙泊酚2mg/kg,维库溴铵0.1mg/kg。Ⅱ组诱导方法:舒芬太尼0.5μg/kg,丙泊酚2mg/kg,维库溴铵0.1mg/kg。插管后控制呼吸,麻醉维持间断追加维库溴铵,丙泊酚,芬太尼(Ⅰ组)或舒芬太尼(Ⅱ组),术中新鲜氧流量设定为2L/min,术中监测患儿生命体征变化及PETCO2,记录插管成功即刻及拔管时患儿MAP、HR、SPO2,观察术毕拔管时间、完全清醒时间及拔管后有无呛咳、喉头水肿、喉痉挛等并发症。结果与Ⅰ组相比,Ⅱ组插管后,HR、Bp明显低于Ⅰ组。术毕拔管时间及完全清醒时间Ⅰ组显著延长,Ⅰ组术毕拔管后并发症明显高于Ⅱ组。结论舒芬太尼用于唇腭裂修复术安全可靠,较传统麻醉方法具有术中麻醉平稳、清醒迅速、术毕并发症少等优点。
Objective To investigate the feasibility of sufentanil used in infant cleft lip and palate repair. Methods Sixty infants with cleft lip and palate repair were randomly divided into two groups: sufentanil group (group Ⅰ) and fentanyl group (group Ⅱ), 30 cases in each group. Group Ⅰ induction method: fentanyl 4μg / kg, propofol 2mg / kg, vecuronium 0.1mg / kg. Group Ⅱ induction method: sufentanil 0.5μg / kg, propofol 2mg / kg, vecuronium 0.1mg / kg. Breathing was controlled after intubation, and verapamil, propofol, fentanyl (group Ⅰ) and sufentanil (group Ⅱ) were interrupted intermittently. The fresh oxygen flow rate was set at 2L / Monitoring changes of vital signs in children and PETCO2, recording the MAP, HR and SPO2 in children with successful intubation and extubation, the time of extubation, the complete awake time and the presence of cough, laryngeal edema and laryngospasm after extubation Other complications. Results Compared with group Ⅰ, HR and Bp in group Ⅱ were significantly lower than those in group Ⅰ after intubation. The extubation time and complete awake time in group Ⅰ were significantly prolonged. The complications after extubation in group Ⅰ were significantly higher than those in group Ⅱ. Conclusion Sufentanil is safe and reliable for the repair of cleft lip and palate. Compared with traditional anesthesia, sufentanil has the advantages of stable intraoperative anesthesia, rapid awakeness and less complications.