ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (2): 140-142.doi: 10.3969/j.issn.1674-3865.2018.02.015

• 临床研究 • 上一篇    下一篇

七氟醚复合瑞芬太尼在耳鼻喉科小儿扁桃体腺样体切除手术中的应用

刘冬冬   

  1. 475000 河南 开封，开封市中心医院麻醉科
  • 出版日期:2018-04-25 发布日期:2018-11-19
  • 作者简介:刘冬冬（1973-），女，副主任医师。研究方向：临床麻醉，E-mail：liu_dong1234@126.com

Application of sevoflurane combined with remifentanil in the surgery for children receiving adenotosillectomy in ENT Department

LIU Dongdong   

  1.  Department of Anesthesiology, Kaifeng Central Hospital，Kaifeng 475000，China
  • Online:2018-04-25 Published:2018-11-19

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摘要：
目的
探讨七氟醚复合瑞芬太尼在耳鼻喉科小儿扁桃体腺样体切除手术中的应用和安全性。
方法
选择2016年5月至10月开封市中心医院耳鼻喉科收治的行扁桃体腺样体手术治疗患儿120例，随机分为观察组和对照组各60例。观察组患儿采用七氟醚复合瑞芬太尼麻醉，对照组患儿采用丙泊酚复合瑞芬太尼麻醉。记录比较两组患儿不同时段心率、收缩压、舒张压的变化，麻醉恢复情况及不良反应发生情况。
结果
两组患儿麻醉前和拔管后5 min的心率、收缩压、舒张压比较差异均无统计学意义（P>0.05）。观察组插管后5 min和手术开始后5 min的心率、收缩压、舒张压均高于对照组，差异有统计学意义(P<0.05)。手术结束后观察组患儿自主呼吸恢复时间、主观意识恢复时间和气管拔管时间均显著短于对照组，差异有统计学意义(P<0.05）。两组患儿均未出现呼吸抑制、心律失常、喉痉挛、喉水肿。观察组躁动、哭闹、恶心呕吐发生率显著低于对照组，差异有统计学意义(P<0.05）。
结论
耳鼻喉科小儿扁桃体腺样体切除手术中，采用七氟醚复合瑞芬太尼麻醉，具有较好的麻醉效果，术中血流动力学影响小，麻醉恢复快，不良反应发生率低，安全性高。

关键词: 麻醉, 七氟醚, 瑞芬太尼, 扁桃体腺样体切除术, 儿童

Abstract:
objective
To investigate the application and safety of sevoflurane combined with remifentanil in the surgery for children receiving adenotosillectomy in ENT Department.
Methods
Totally 120 cases of children undergoing adenotosillectomy from May 2016 to October in Department of ENT, Kaifeng Central Hospital were chosen and randomly divided into observation group and control group, 60 cases in each group; the observation group were treated with sevoflurane combined with remifentanil anesthesia, and the control group were treated with propofol with remifentanil anesthesia; the records were compared between the two groups of children concerning heart rate，systolic and diastolic blood pressure changes at different time, recovery of anesthesia, and incidence of adverse reactions.
Results
There was no significant difference in heart rate, systolic or diastolic blood pressure before anesthesia and 5 minutes after extubation in two groups(P>0.05). The heart rate, systolic and diastolic blood pressure were significantly higher in the observation group than in the control group 5 minutes after intubation and 5 minutes after the operation, the difference being statistically significant(P<0.05).After surgery the recovery time of spontaneous breathing and subjective consciousness and tracheal extubation time were significantly shorter in the observation group, which was statistically significant(P<0.05). No respiratory depression，arrhythmia，larygospasm or laryngeal edema were found in both groups. The incidence of adverse reactions(restlessness, crying, nausea and vomiting) in the observation group was significantly lower than that in the control group, the difference being statistically significant(P<0.05).
Conclusion
In the process of adenotosillectomy for children in department of ENT, the use of sevoglurane combined with remifentanil anesthesia has good effects of anesthesia, with stable hemodynamics, quick recovery and low incidence of adverse reactions, and is safer.

Key words: Anesthesia, Sevoflurane, Remifentanil, Adenotosillectomy, Children