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目的观察泵注瑞芬太尼复合丙泊酚静脉麻醉在婴幼儿腹腔镜手术中应用的效果。方法3岁以下行腹腔镜斜疝修补术病人60例,随机分两组,A组(n=30),吸入异氟醚进行气管内麻醉,B组(n=30),泵注瑞芬太尼复合丙泊酚静脉麻醉,观察麻醉过程中血压心率,停药后自主呼吸恢复、呼之睁眼及拔管时间,术后止痛药需求时间,麻醉后不良反应。结果①A组病人在人工气腹及气管拔管时血压及心率显著升高,B组病人麻醉后各时段均表现为显著的心率及血压下降。②B组自主呼吸恢复时间、呼之睁眼时间、拔管时间、术后离床时间均较A组提前22%～47%不等,有显著差异。③B组术后对止痛药物需求早于A组。④A组术后呕吐、低血氧高于B组。结论与常规吸入全麻行婴幼儿腹腔镜斜疝修补术比较,泵注瑞芬太尼复合丙泊酚静脉麻醉效果更确切,苏醒快而且苏醒质量好。由于半衰期短,需及时开始术后镇痛。
Objective To observe the effect of intravenous injection of remifentanil combined with propofol intravenous anesthesia in infantile laparoscopic surgery. Methods Sixty patients undergoing laparoscopic oblique hernia repair under the age of 3 were randomly divided into two groups: group A (n = 30), endotracheal intubation with isoflurane, group B (n = 30), and remifentanil Nifedipine propofol intravenous anesthesia, anesthesia during the observation of blood pressure and heart rate, spontaneous respiratory withdrawal after withdrawal, call the eyes and extubation time, postoperative analgesic demand time, adverse reactions after anesthesia. Results ① The blood pressure and heart rate of patients in Group A were significantly higher than those in patients with pneumoperitoneum and tracheal extubation. The patients in Group B showed marked decrease in heart rate and blood pressure at various time points after anesthesia. ②B group spontaneous breathing recovery time, call the eyes open time, extubation time, after bed departure time than the A group 22% to 47% ahead of schedule, there were significant differences. ③ Group B postoperative pain medication demand earlier than the A group. ④ A group postoperative vomiting, hypoxemia higher than the B group. Conclusion Compared with conventional laparoscopic oblique hernia repair in general anesthesia, the effect of intravenous injection of remifentanil and propofol is more accurate, faster recovery and better recovery. Due to short half-life, it is necessary to start postoperative analgesia.