【摘要】 目的:研究瑞芬太尼在患儿上肢骨折手术中的安全泵注速度范围。方法:选择25例2～12岁上肢骨折患儿,面罩吸氧,未行气管内插管,手术开始前泵注瑞芬太尼,泵注速度从0.100μg/(kg·min)开始,之后每间隔5min增加0.025μg/(kg·min),直至出现呼吸抑制。观察不同瑞芬太尼泵注速度时患儿的心率、呼吸、脉搏、血氧饱和度、血压、呼气末二氧化碳和体动情况。结果:3名患儿在泵注速度0.175μg/(kg·min)时出现呼吸抑制,18名患儿在泵注速度0.200μg/(kg·min)时出现呼吸抑制,4名患儿在泵注速度0.225μg/(kg·min)时出现呼吸抑制。停药和加压面罩给氧后所有患儿呼吸恢复,术后患儿无呼吸抑制、恶心呕吐、躁动和苏醒延迟等并发症发生。结论:小儿瑞芬太尼泵注引起呼吸抑制的ED05为0.17023μg/(kg·min),ED50为0.18806μg/(kg·min),ED95为0.20775μg/(kg·min)。更多还原

【Abstract】 Objective To study the reasonable infusion speed of remifentanil in the operation of children with upper limb.Methods A total of 25 children,aged 2-12 years,undergoing arm-fracture operation,breathing oxygen with opening veil,were enrolled in the study.Remifentanil was administered in an initial infusion concentration of 0.100 μg/(kg·min),and then was increased by 0.025 μg/(kg·min) for every 5 minutes until respiratory depression occurred.Heart rate,breath rate,pulse,oxyhemoglobin saturation,blood pressure,carbon dioxide concentration at the end of expiration,and body movement were observed at every infusion speed.Results Respiratory depression occurred in 3 children at the rate of 0.175 μg /(kg·min),in 18 children at 0.200 μg /(kg·min),and in 4 children at 0.225 μg /(kg·min),but all the 25 children retrieved normal breathing at the time remifentanil infusion was stopped and mask oxygen inhalation was given.No complications of respiratory depression,nausea and vomiting,restlessness,and palinesthesia delay were observed.Conclusion The dosages of remifentanil causing respiratory depression are:ED05 = 0.170 23 μg /(kg·min),ED50 = 0.188 06 μg /(kg·min),ED95 =0.207 75 μg /(kg·min).更多还原