中国临床药学杂志

目的探讨七氟烷联合瑞芬太尼在小儿日间手术麻醉中的应用效果。方法 2013年2月至2016年12月选择进行择期唇腭裂修补术患儿66例,随机分为2组,每组33例。对照组给予氯胺酮联合丙泊酚麻醉,观察组给予七氟烷联合瑞芬太尼麻醉,记录2组麻醉效果与苏醒情况。结果所有患儿在麻醉诱导后(T1)、手术开始时(T2)、手术开始后5 min(T3)、手术结束时(T4)的心率和血氧饱和度均表现正常,组内与组间差异都无统计学意义(P> 0. 05)。观察组患儿的自主睁眼时间与拔管时间分别为(7. 62±2. 48) min和(9. 90±4. 22) min,都低于对照组的(12. 89±4. 22) min和(16. 33±7. 28) min(P <0. 05)。观察组患儿围术期躁动、喉水肿、屏气和呛咳等并发症发生率为6. 1%,低于对照组的36. 4%(P <0. 05)。结论七氟烷联合瑞芬太尼应用于小儿日间手术麻醉,能维持患儿生命体征稳定,麻醉诱导迅速,术毕苏醒快,能减少围术期并发症的发生。

AIM To discuss the anesthetic effects of sevoflurane combined remifentanil in pediatric day surgery. METHODS From February 2013 to December 2016,66 children in our hospital for elective cleft lip and palate repair were randomly divided into 2 groups,with 33 children in each group. The control group was given ketamine combined with propofol anesthesia,the observation group was given sevoflurane combined with remifentanil anesthesia,and anesthesia and recovery situation of two groups were recorded. RESULTS The heart rate and blood oxygen saturation of all children after induction of anesthesia(T1),at the beginning of operation(T2),5 min after operation(T3) and at the end of operation(T4) were within the normal range,and there were no significant differences between the 2 groups(P > 0. 05). The time of eye opening and the time of extubation were(7. 62 ± 2. 48) min and(9. 90 ± 4. 22) min in the observation group,which were lower than(12. 89 ± 4. 22) min and(16. 33 ± 7. 28) min in the control group(P < 0. 05). The perioperative period incidences of complications such as restlessness,laryngeal edema,breath holding and coughing were 6. 1% in the observation group,and were36. 4% in the control group respectively,and those in the observation group were lower than those in the control group(P < 0. 05). CONCLUSION The application of sevoflurane combined with remifentanil in pediatric day surgery can maintain the children stable vital signs,accelerate the induction time of anesthesia and increase the postoperative recovery quickly,so it has good application values.