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目的观察不同剂量瑞芬太尼和丙泊酚用于小儿无痛肠镜的麻醉效果及并发症发生情况。方法 90例备行肠镜检查患儿随机分为三组,即0.01μg/(kg·min)瑞芬太尼(A组)、0.02μg/(kg·min)瑞芬太尼(B组)和0.03μg/(kg·min)瑞芬太尼(C组),各30例。观察并记录各组患者麻醉前、肠镜插入时、检查中、清醒时各时间点时的血压(BP)、心率(HR)、呼吸频率(RR)、血氧饱和度(Sp O2)变化、并发症发生情况及苏醒时间。结果三组均为无痛肠镜提供有效的镇痛,但C组麻醉效果最优,丙泊酚用量少,血流动力学相对平稳,喉或支气管痉挛、呛咳及呼吸抑制发生率低,苏醒时间短(P<0.05)。结论瑞芬太尼复合丙泊酚应用于小儿无痛肠镜检查麻醉深度易控制、安全平稳,术后苏醒迅速,并发症少,镇痛效果满意,以0.03μg/(kg·min)为宜。
Objective To observe the anesthesia effects and complications of different doses of remifentanil and propofol in pediatric painless colonoscopy. Methods Ninety children undergoing colonoscopy were randomly divided into three groups: remifentanil (0.01μg / (kg · min)), remifentanil (0.02μg / (kg · min)) and remifentanil (group B) And 0.03μg / (kg · min) remifentanil (group C), 30 cases each. The changes of blood pressure (BP), heart rate (HR), respiratory rate (RR) and blood oxygen saturation (Sp O2) before anesthesia, at the time of colonoscopy insertion, Complications and wake up time. Results All the three groups were effective analgesia for painless colonoscopy. However, group C had the best anesthetic effect, less propofol consumption, relatively stable hemodynamics, low throat or bronchospasm, cough and respiratory depression , Recovery time is short (P <0.05). Conclusion The combination of remifentanil and propofol in children with painless colonoscopy is easy to control the anesthesia depth, which is safe and stable. The remifentanil combined with propofol can wake up quickly after operation, with fewer complications and satisfactory analgesic effects. The best dosage of remifentanil is 0.03μg / (kg · min) .