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目的比较瑞芬太尼和氯胺酮用于小儿静脉复合麻醉的血流动力学变化,体动反应情况,苏醒时间和外科医生满意度。方法选择择期手术小儿50例,随机分入瑞芬太尼组(R组)26例和氯胺酮组(K组)24例。术中适当调整瑞芬太尼的输脉注射速率和氯胺酮静脉注射以维持满意的麻醉深度。术中连续监测心电图(ECG)、血压(Bp)、呼吸(R)、心率(HR)、脉搏血氧饱和度(SpO2)。记录手术结束停药至患儿苏醒的间隔时间,体动发生情况及外科医生的满意度。结果两组患者手术开始前平均动脉压(MAP)和HR比较差异无统计学意义。手术开始后R组的MAP、HR、R明显低于K组(P<0.05)。R组的苏醒时间明显短于K组,体动发生率R组明显低于K组。外科医生满意度R组高于K组。结论瑞芬太尼复合丙泊酚用于小儿静脉复合麻醉可提供稳定的血流动力学状态。术后快捷苏醒并获得外科医生较高的满意度。
Objectives To compare the hemodynamic changes of remifentanil and ketamine in pediatric intravenous anesthesia, motor response, wake time and surgeon satisfaction. Methods Fifty children with elective surgery were randomly divided into remifentanil group (n = 26) and ketamine group (n = 24). Intraoperative injection of remifentanil infusion rate and ketamine appropriate intravenous injection to maintain a satisfactory depth of anesthesia. During operation, electrocardiogram (ECG), blood pressure (Bp), respiration (R), heart rate (HR) and pulse oxygen saturation (SpO2) were continuously monitored. Record the interval between the withdrawal from the end of surgery to the recovery of the affected children, the incidence of physical activity and the surgeon’s satisfaction. Results There was no significant difference in mean arterial pressure (MAP) and HR between the two groups before surgery. The MAP, HR and R in R group after operation were significantly lower than those in K group (P <0.05). The recovery time of group R was obviously shorter than that of group K, and the rate of group R was significantly lower than group K. Surgeon satisfaction R group was higher than K group. Conclusion Remifentanil combined with propofol for pediatric intravenous anesthesia provides stable hemodynamic status. Quick wake up after surgery and get higher satisfaction surgeons.