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目的观察全麻插管患儿在气管拔管时靶控输注异丙酚预防拔管期不良反应的有效性及可行性。方法选择择期行唇腭裂手术患儿28例,随机分为靶控输注(T)与生理盐水对照组(C)两组。诱导采用芬太尼2μg/kg,异丙酚2.5mg/kg及维库溴铵0.1mg/kg后插管,维持采用2%～3%七氟醚,在手术结束前5min停药。停药后,T组(n=14例)患儿行异丙酚靶控输注,血浆靶控浓度为1ug/ml,至气管拔管后5min停药;C组(n=14例)处理同P组,但以生理盐水TCI作为对照。记录TCI开始前、吸痰时、拔管时、拔管后5、10min的MAP和HR,同时记录两组患儿的RR、SPO2、呼吸恢复时间、睁眼时间、拔管时间和躁动、恶心呕吐、术后出血等不良反应。结果T组病人在血流动力学方面比C组病人平稳,拔管时间较C组短,且术后躁动、恶心呕吐较C组发生率低(P<0.05)。结论拔管期靶控输注异丙酚可有效预防拔管时的应急反应及不良反应。
Objective To observe the effectiveness and feasibility of target-controlled infusion of propofol in preventing tracheal exacerbation during tracheal extubation in children undergoing general anesthesia with intubation. Methods Twenty-eight children undergoing elective cleft lip and palate surgery were randomly divided into two groups: target controlled infusion (T) and saline control group (C). Induction with fentanyl 2μg / kg, propofol 2.5mg / kg and vecuronium 0.1mg / kg after intubation, maintaining 2% to 3% sevoflurane, stopping 5min before the end of surgery. After discontinuation, the target-controlled infusion of propofol was administered to children in group T (n = 14). The target concentration of plasma was 1ug / ml, and the drug was stopped 5 minutes after tracheal extubation. Group C (n = 14) The same group P, but with saline TCI as a control. The MAP and HR at 5, 10 min after extubation, sputum aspiration, extubation, TC, RR, SPO2, respiration recovery time, eyes open time, extubation time and agitation, nausea Vomiting, postoperative bleeding and other adverse reactions. Results The patients in group T were more stable in hemodynamics than those in group C, and the extubation time was shorter than that in group C. The incidence of agitation and nausea and vomiting was lower in group T than that in group C (P <0.05). Conclusion Target-controlled infusion of propofol during extubation can effectively prevent extubation emergency response and adverse reactions.