靶控输注异丙酚和异丙酚复合瑞芬太尼镇静在小儿埋伏多生牙拔除手术中应用的比较

发布时间：2018-06-05 03:18

本文选题：异丙酚 + 瑞芬太尼　；参考：《华西口腔医学杂志》2017年04期

【摘要】：目的对靶控输注异丙酚和异丙酚复合瑞芬太尼2种镇静方法在小儿埋伏多生牙拔除手术中的应用进行比较。方法将60例接受上前牙区埋伏多生牙拔除术的患儿随机分为2组:异丙酚组(P组,n=30)和异丙酚复合瑞芬太尼组(PR组,n=30)。P组:滴定法靶控输注异丙酚至改良OAA/S评分3分时进行手术。PR组:靶控输注瑞芬太尼目标浓度为1 ng·mL-1,滴定法靶控输注异丙酚至改良OAA/S评分3分时进行手术。采用Houpt行为治疗效果评分评估2组患儿术中配合情况,记录2组患儿心率、血压、血氧饱和度、呼吸频率和Narcotrend指数(NI),以及相关并发症、不良反应及药物输注情况。结果 Houpt行为治疗效果评分PR组优于P组(P0.05)。血氧饱和度、呼吸频率PR组低于P组(P0.05),心率、血压及NI值2组无统计学差异(P0.05)。呼吸抑制和顺行性遗忘的发生率,PR组高于P组(P0.05)。结论在小儿埋伏多生牙拔除术中,靶控输注异丙酚和靶控输注异丙酚复合瑞芬太尼镇静这2种方法都是安全有效的。在吸氧状态下,靶控输注异丙酚复合瑞芬太尼镇静优于异丙酚镇静。
[Abstract]:Objective to compare the two sedation methods of target controlled infusion of propofol and propofol combined with remifentanil in the extraction of ambush supernumerary teeth in children. Methods Sixty children undergoing ambushed extraction of overlying teeth were randomly divided into two groups: propofol group (P group) and propofol combined with remifentanil group (PR group). Group P: target controlled infusion of propofol by titration to the modified OAA/S score of 3 points. Group PR: target controlled infusion of remifentanil was 1 ng ml ~ (-1), target controlled infusion of propofol by titration and modified OAA/S score 3 min. Houpt behavioral therapy score was used to evaluate the intraoperative cooperation, heart rate, blood pressure, blood oxygen saturation, respiratory frequency and Narcotrend index, as well as related complications, adverse reactions and drug infusion were recorded in the two groups. Results the score of Houpt behavioral therapy effect in PR group was better than that in P group (P 0.05). Blood oxygen saturation and respiratory rate in PR group were lower than that in P group (P 0.05). There was no significant difference in heart rate, blood pressure and NI value between two groups. The incidence of respiratory inhibition and antegrade amnesia in PR group was higher than that in P group (P 0.05). Conclusion both target-controlled infusion of propofol and target-controlled infusion of propofol combined with remifentanil sedation are safe and effective in the extraction of ambush supernumerary teeth in children. Target controlled infusion of propofol combined with remifentanil was superior to propofol sedation under oxygen uptake.
【作者单位】：河北医科大学口腔医院口腔颌面外科河北省口腔医学重点实验室;
【基金】：河北省卫生计生委医学科学研究重点课题(20150816)~~
【分类号】：R782.11

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