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目的比较七氟烷-瑞芬太尼和咪达唑仑-瑞芬太尼用于小儿唇腭裂手术的麻醉效果和安全性。方法选择60例择期行唇腭裂修复术的患儿为研究对象,随机分为两组,每组30例。七氟烷组(S组)采用七氟烷和瑞芬太尼麻醉,咪达唑仑组(M组)采用咪达唑仑、瑞芬太尼和维库溴铵麻醉。记录两组患儿在麻醉诱导前(T1)、手术中(T2)、手术后(T3)的心率(HR)、平动脉压(MAP)、脉搏血氧饱和度(SpO2),并记录苏醒时间、苏醒期躁动以及恶心呕吐和气道并发症的发生情况。结果两组患儿的性别、年龄、体重和手术时间比较差异均无统计学意义。T2时点的MAP、HR明显低于T1、T3时点,M组患儿苏醒时间、离室时间和嗜睡均明显高于S组,S组恶心呕吐和苏醒期躁动明显高于M组,两组比较差异均有统计学意义(P<0.05)。结论两种麻醉方法各有优点,都能较安全的用于此手术。
Objective To compare the anesthetic effect and safety of sevoflurane-remifentanil and midazolam-remifentanil in children with cleft lip and palate. Methods Sixty children with elective cleft lip and palate repair were randomly divided into two groups (n = 30 in each group). Sevoflurane group (group S) was anesthetized with sevoflurane and remifentanil, midazolam group (group M) was anesthetized with midazolam, remifentanil and vecuronium. The heart rate (HR), MAP and pulse oxygen saturation (SpO2) were recorded before anesthesia induction (T1), during surgery (T2) and after surgery (T3) , Restlessness during wakefulness, and nausea and vomiting and airway complications. Results There was no significant difference in gender, age, weight and operation time between the two groups. The MAP and HR at T2 were significantly lower than those at T1 and T3, and the recovery time, departure time and drowsiness in M group were significantly higher than those in S group. The incidence of nausea and vomiting in S group was significantly higher than that in M group The difference was statistically significant (P <0.05). Conclusion The two anesthesia methods have their own advantages, can be more safely used for this operation.