七氟烷或丙泊酚复合瑞芬太尼用于小儿全身麻醉的效果比较

发布时间：2018-04-24 15:16

本文选题：七氟烷 + 丙泊酚　；参考：《慢性病学杂志》2016年05期

【摘要】：目的比较两种全身麻醉方式(七氟烷复合瑞芬太尼与丙泊酚复合瑞芬太尼)在小儿全身麻醉的应用效果差异。方法选择行择期全身麻醉手术的患儿80例,随机分为A、B两组,各40例。A组采用七氟烷吸入复合瑞芬太尼靶控输注麻醉,B组采用丙泊酚复合瑞芬太尼靶控输注麻醉,A、B两组均采用经喉罩全身麻醉并在听觉诱发电位指数监测指导下进行。比较两组患儿在进入手术室诱导前(T1)、插入喉罩前(T2)、插入喉罩时(T3)、插入喉罩后(T4)、切皮时(T5)、手术15 min时(T6)、手术30 min时(T7)、手术1 h(T8)、手术结束时(T9)及出手术室时(T10)共10个时间段的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP),并比较两组患儿停止麻醉至拔除喉罩的时间及术后并发症发生率的比例差异。结果两组患儿的平均年龄、平均身高及体质量、性别差异、手术类型比例等差异无统计学意义(P0.05)。而两组的HR、SBP、DBP、MAP在T1、T2、T3、T4、T5等5个时间点上差异无统计计学意义(P0.05),而T6~T10等5个时间点上差异有统计学意义(均P0.05)。A、B两组拔除喉罩时间无明显差异[(12.6±4.6)vs.(13.8±5.2)min,P0.05],而A组术后并发症的发生率(27.50%)低于B组(50.00%),差异有统计学意义(P0.05)。结论七氟烷复合瑞芬太尼麻醉方式较丙泊酚复合瑞芬太尼用于小儿全身麻醉具有更稳定的术中血流动力学,术后并发症的发生率更低的优势。
[Abstract]:Objective to compare the effects of two general anesthesia methods (seven fluorothane combined with propofol and propofol combined with remifentanil) in pediatric general anesthesia. Methods 80 cases of children undergoing general anesthesia were randomly divided into A, B two, 40.A group and seven fluorothane combined with remifentanil for target controlled infusion, and B in group B. The target controlled infusion of propofol combined with remifentanil, A, B two groups were conducted under the guidance of the laryngeal mask general anesthesia and the auditory evoked potential index. The two groups were compared to the operation room before induction (T1), insertion of the laryngeal mask (T2), insertion of the laryngeal mask (T3), the insertion of the laryngeal mask (T4), the skin cutting (T5), the operation 15 min (T6), and the operation 30 min (T7). The heart rate (HR), systolic pressure (SBP), diastolic pressure (DBP) and mean arterial pressure (MAP) were performed at 1 h (T8), end of operation (T9) and operation room (T10), and the ratio of the time of stopping anesthesia to extraction of larynx and the incidence of postoperative complications in the two groups were compared. Results the average age, average height and body mass of the two groups were compared. There was no statistical significance (P0.05) for the difference of sex and the proportion of surgical types, but there were no statistical significance (P0.05) in the 5 time points of the two groups, such as T1, T2, T3, T4, T5, etc. at the 5 time points of T1, T2, T3, T4, T5 and so on. There was no significant difference between the 5 time points of T6~T10 and other two groups [(12.6 + 4.6) (13.8 + 5.2). 0.05], and the incidence of postoperative complications in group A (27.50%) was lower than that in group B (50%), and the difference was statistically significant (P0.05). Conclusion seven fluorane compound remifentanil combined with propofol and remifentanil for pediatric general anesthesia has more stable intraoperative hemodynamics and lower incidence of postoperative complications.

【作者单位】：广州市番禺区何贤纪念医院;
【基金】：广东省中医药局基金资助项目(20151034)
【分类号】：R726.1

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