瑞芬太尼联合丙泊酚靶控输注维持麻醉在扁桃体切除术患儿中的应用效果

肖俊伟 翟宇佳 辜慧

[摘要]目的 探討瑞芬太尼联合丙泊酚靶控输注维持麻醉在扁桃体切除术患儿中的应用效果。方法 选取2016年1月1日～2019年6月30日我院120例拟行扁桃体切除术患儿，按照随机数字表法分为对照组和实验组，每组各60例，对照组予以丙泊酚和芬太尼诱导麻醉，异氟烷吸入维持麻醉。实验组予以瑞芬太尼联合丙泊酚靶控输注维持麻醉。比较两组患儿血流动力学指标（平均动脉压、心率、血氧饱和度）参数、拔管时间、自主呼吸恢复时间、苏醒时间、并发症总发生率。结果 两组患儿术前的平均动脉压、心率、血氧饱和度比较，差异无统计学意义（P>0.05）;实验组患儿插管后1 min、切除时、拔管时、清醒时的平均动脉压、心率均低于对照组，差异有统计学意义（P<0.05）;实验组拔管时间、自主呼吸恢复时间、苏醒时间均短于对照组，差异有统计学意义（P<0.05）;两组患儿插管后1 min、切除时、拔管时、清醒时的血氧饱和度比较，差异无统计学意义（P>0.05）;实验组并发症总发生率（8.34%）低于对照组（25.00%），差异有统计学意义（P<0.05）。结论 瑞芬太尼联合丙泊酚靶控输注维持麻醉可维持扁桃体切除术患儿围术期的血流动力学平稳，苏醒时间缩短，并发症少，具有良好的麻醉效果。

[关键字]扁桃体切除术;瑞芬太尼;血流动力学;丙泊酚

[中图分类号] R614          [文献标识码] A          [文章编号] 1674-4721（2020）6（b）-0151-04

[Abstract] Objective To investigate the effect of Remifentanil combined with Propofol target-controlled infusion on maintenance anesthesia in children with tonsillectomy. Methods A total of 120 children who were planned to undergo tonsillectomy in our hospital from January 1， 2016 to June 30， 2019 were selected and divided into control group and experimental group according to random number table method， with 60 children in each group. The control group was given Propofol and Fentanyl induced anesthesia， and anesthesia was maintained by inhalation of Isoflurane. The experimental group was given Remifentanil combined with Propofol target-controlled infusion to maintain anesthesia. The hemodynamic parameters （mean arterial pressure， heart rate， blood oxygen saturation） parameters， extubation time， spontaneous breathing recovery time， wake time and the total incidence of complication were compared. Results The mean arterial pressure， heart rate and blood oxygen saturation of the two groups were compared， and the differences were not statistically significant （P>0.05）. The mean arterial pressure and heart rate in the experimental group 1 min after intubation， excision， and extubation were lower than those in the control group， and the differences were statistically significant （P<0.05）. The extubation time， spontaneous breathing recovery time， and wake-up time in the experimental group were shorter than those in the control group， with statistical differences significance （P<0.05）. There were no significant differences in blood oxygen saturation between the two groups of patients at 1 min after intubation， at the time of resection， at the time of extubation， and at consciousness （P>0.05）. The total incidence of complications in the experimental group （8.34%） was lower than the control group （25.00%）， and the difference was statistically significant （P<0.05）. Conclusion Remifentanil combined with Propofol target-controlled infusion on maintenance anesthesia can maintain stable hemodynamics during perioperative period in children with tonsillectomy， shortened wake-up time， fewer complications and has a good anesthetic effect.

[Key words] Tonsillectomy; Remifentanil; Hemodynamics; Propofol

扁桃体病变是小儿常见疾病，表现为呼吸道的不通畅，由小儿的扁桃体感染、肥大与增生等原因造成，甚至会出现呼吸困难和吞咽不便，扁桃体摘除术是主要的治疗方法[1-2]。……