【摘要】 目的比较瑞芬太尼和芬太尼用于小儿唇腭裂整复术麻醉时的血流动力学变化和苏醒时间。方法选择40例择期先天性唇腭裂整复术患儿,随机分成瑞芬太尼组(R组)和芬太尼组(F组),每组20例。麻醉诱导以咪哒唑仑0.15mg/kg、维库溴铵0.1mg/kg、丙泊酚2mg/kg静注,R组缓慢静注瑞芬太尼1μg/kg,F组静注芬太尼3μg/kg,面罩给氧3分钟后气管插管。R组以瑞芬太尼0.2-0.3μg/(kg·min)静脉泵注,于术毕停止输注;F组根据手术时间追加芬太尼。两组均以丙泊酚4-8mg/(kg·h)静脉泵注,于术毕前10分钟停止输注。术中并用肌松药维持麻醉,手术局部注射1%利多卡因和1∶200000肾上腺素。监测插管前,插管后5、20、50分钟两组HR、BP,记录拔管时间。结果两组患儿插管前及插管后5分钟HR、BP无显著变化;插管后20、50分钟R组HR、BP低于F组(P<0.05),拔管时间短于F组(P<0.05)。结论静脉持续输注瑞芬太尼用于小儿唇腭裂整复术,麻醉维持效果好且苏醒快。更多还原

【Abstract】 Objective To compare the hemodynamic changes and recovery time of remifentanil and those of fentanyl for pediatric cheilopalatognathus diorthosis.Methods 40 congenital cheilopalatognathus children were randomly divided into remfentanil group(R,n=20)and fentanyl group(F,n=20).For both groups,anesthesia induction was done intravenously with midazolam 0.15mg/kg,vecuronium 0.1mg/kg,propofol 2mg/kg.Meanwhile,remifentanil 1μg/kg was slowly introvenously injected in group R and fentanyl 3μg/kg in group F.And for group R,0.2-0.3μg/(kg·min)of remifentanil was continuously injected with syringe pump and stopped right after surgery.For group F,fentanyl was reused according to the length of surgery.4-8mg/(kg·h)of propofol was intravenously syringe-pumped for both groups and stopped 10 minutes before the surgery.In the mean time,muscle relaxant was used intraoperatively and lidocaine1% by the addition of epinephrine 1∶200000 was injected locally.HR and BP were monitored before intubation and 5min,20min,50min after intubation and extubation time was recorded.Results HR and BP did not change significantly before intubation and within 5min.after intubation but were lower in group R than those in group F(P<0.05)during 20min,50min after intubation.And also,extubation time in group R was shorter than that in group F(P<0.05).Conclusion Anesthesia by continuous,intravenous syringe pump injection of remifentanil for pediatric cheilopalatognathus diorthosis has a good effectiveness and quick recovery of anesthesia.更多还原