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目的探讨瑞芬太尼在小儿上肢骨折手术麻醉中的有效性和安全性。方法选择2012年6月至2014年1月上肢骨折手术患儿70例,按应用的麻醉药物不同分为瑞芬太尼组和芬太尼组。两组均采用面罩吸氧,未气管插管,仅手术开始分别泵注瑞芬太尼和芬太尼。观察两组麻醉效果、苏醒时间和不良反应。结果瑞芬太尼组患儿镇痛起效时间(3.14±0.57)min,术中疼痛感和牵扯感(1.26±0.09)分,苏醒时间(5.10±2.04)min,不良反应发生率为7.84%,脉搏氧饱和度、心率、血压、呼吸、呼气末二氧化碳分压值均比芬太尼组有优势,差异有统计学意义(P<0.05)。结论瑞芬太尼在小儿上肢骨折手术时,镇痛效果好,术后苏醒快,不良反应少,更适合儿童应用。
Objective To investigate the effectiveness and safety of remifentanil in anesthesia of pediatric upper limb fractures. Methods Seventy patients with upper extremity fracture surgery from June 2012 to January 2014 were divided into remifentanil group and fentanyl group according to the anesthetic drugs used. Both groups were treated with masks oxygen, no endotracheal intubation, only the beginning of surgery were remifentanil and fentanyl pump. Two groups were observed anesthesia, recovery time and adverse reactions. Results The onset time of analgesia (3.14 ± 0.57) min, intraoperative pain and traction (1.26 ± 0.09), recovery time (5.10 ± 2.04) min and adverse reactions in remifentanil group were 7.84% , Pulse oxygen saturation, heart rate, blood pressure, respiration, end-tidal carbon dioxide partial pressure than fentanyl group has the advantage, the difference was statistically significant (P <0.05). Conclusion Remifentanil in children with upper extremity fracture surgery, analgesic effect, rapid recovery after surgery, fewer adverse reactions, more suitable for children.