| 摘要: |
| [摘要]目的：研究并探讨丙泊酚复合瑞芬太尼全凭静脉麻醉在小儿腹腔镜手术中的应用效果。方法：入组对象选择2015年6月至2017年6月期间我院收治的400例小儿腹腔镜手术患儿，按随机数字表法分为两组各200例，对照组采用瑞芬太尼复合七氟醚静吸复合麻醉，观察组采用瑞芬太尼复合丙泊酚全凭静脉麻醉，比较两组患儿的麻醉效果、麻醉起效时间、麻醉维持时间、血流动力学指标、自主呼吸恢复时间、睁眼时间、拔管时间、不良反应发生率。结果：观察组的麻醉优良率为97.50%，对照组为98.50%，组间比较差异无统计学意义（P>0.05）。观察组的麻醉起效时间（6.95±2.14）min，麻醉维持时间（48.23±11.25 ）min，与对照组的（6.73±2.28）min、（49.42±10.64）min比较差异无统计学意义（P>0.05）。两组麻醉后的平均动脉压、心率、动脉血氧分压较麻醉前均无明显变化（P>0.05）,差异无统计学意义（P>0.05）。与对照组比较，观察组的术后自主呼吸恢复时间（5.19±1.87） min、睁眼时间（7.85±2.60）min、拔管时间（9.56±2.94）min均缩短（P<0.05）。观察组不良反应总发生率为4.50%，对照组为10.50%，差异有统计学意义（P<0.05）。结论：采用丙泊酚复合瑞芬太尼全凭静脉麻醉用于小儿腹腔镜手术中可达到与瑞芬太尼复合七氟醚静吸复合麻醉相当的麻醉效果，但丙泊酚复合瑞芬太尼全凭静脉麻醉方案的安全性更高，可加快患者术后意识恢复，减少不良反应发生。 |
| 关键词: 儿童 腹腔镜手术 丙泊酚 瑞芬太尼 全凭静脉麻醉 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2020.01.007 |
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| 基金项目: |
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| Propofol Combined with Remifentanil in Total Intravenous Anesthesia for Children Undergoing Laparoscopic Surgery |
| Zeng Zhaohe, Zou Cuiyun |
| (The Second Maternal and Child Health Hospital of Guangdong Huizhou, Guangdong Huizhou 516001, China) |
| Abstract: |
| [Abstract] Objective: To investigate the application of propofol combined with remifentanil in total intravenous anesthesia for children undergoing laparoscopic surgery. Methods: Totally 400 children undergoing laparoscopic surgery in our hospital from Jun. 2015 to Jun. 2017 were extracted to be divided into the observation group and the control group via the random number table, with 200 cases in each group. The control group was treated with remifentanil combined with sevoflurane, while the observation group received remifentanil combined with propofol. Anaesthesia effects, onset time of anaesthesia, maintenance time of anaesthesia, hemodynamic indexes, recovery time of spontaneous respiratory, eye-opening time, extubation time and incidence of adverse drug reactions of two groups were compared. Results: The excellent rate of anesthesia in the observation group was 97.50%, while that in the control group was 98.50%, without any statistically significant difference (P>0.05). The onset time and maintenance time of anesthesia in the observation group were respectively (6.95±2.14) min and (48.23±11.25) min, compared with (6.73±2.28) min and (49.42±10.64) min in the control group, there was no statistically significant difference (P>0.05). There was no significant change in the mean arterial pressure, heart rate and arterial oxygen pressure after anesthesia between two groups (P>0.05), and the difference was not statistically significant (P>0.05). Compared with the control group, the postoperative recovery time of spontaneous respiratory (5.19±1.87) min, eye-opening time (7.85±2.60) min and extubation time (9.56±2.94) min were shorter in the observation group (P<0.05). The total incidence of adverse drug reactions was 4.50% in the observation group and 10.50% in the control group, with statistically significant differences (P<0.05). Conclusion: The application of propofol combined with remifentanil in total intravenous anesthesia for children undergoing laparoscopic surgery can achieve the same anesthetic effect as that of remifentanil combined with sevoflurane. However, the safety of propofol combined with remifentanil in total intravenous anesthesia is higher, which can accelerate postoperative consciousness recovery and reduce adverse drug reactions. |
| Key words: children laparoscopic surgery propofol remifentanil total intravenous anesthesia |
