舒芬太尼与瑞芬太尼在小儿扁桃体、腺样体切除手术中麻醉的比较

    Comparison of sufentanil and remifentanil in the anesthesia of pediatric tonsillectomy and adenoidectomy surgery

    • 摘要: 目的:观察舒芬太尼与瑞芬太尼在小儿扁桃体、腺样体切除手术中及术后的镇痛和镇静作用。方法:选择择期进行扁桃体、腺样体切除手术的患儿100例,随机分为舒芬太尼组(S组)50例和瑞芬太尼组(R组)50例。S组以舒芬太尼0.2μg/kg快速诱导,以0.2μg·kg-1·h-1术中维持,手术结束前30 min停药。R组以瑞芬太尼2μg/kg快速诱导,以6μg·kg-1·h-1术中维持,手术结束前5 min停药。分别观察2组术中、术后血流动力学指标及术后患儿镇痛和镇静程度。结果:2组术中血流动力学指标差异无统计学意义(P>0.05)。拔管后5 min时S组平均动脉压与基础值差异无统计学意义;R组HR较S组明显增高(P<0.01)。S组患儿术后Ramsay评分较适宜,VAS评分较低。结论:两种药物均能较好地用于小儿扁桃体、腺样体切除手术,舒芬太尼在提高术后麻醉恢复质量上和安全性上更有优势。

       

      Abstract: Objective:To observe the analgesic and sedative effects of sufentanil and remifentanil during and after pediatric tonsillectomy and adenoidectomy surgery.Methods:One hundred patients involved in selective operation were chosen and divided into two groups randomly:sufentanil group (S group,n=50) and remifentanil group (R group,n=50).Patients in S group were rapidly induced by 0.2 μg/kg sufentanil,and were maintained with 0.2 μg·kg-1·h-1 in the operation.Sufentanil was withdrawn 30 min before the operation completed.Patients in R group were rapidly induced by 2 μg/kg remifentanil,and were maintained with 6 μg·kg-1·h-1 in the operation.Remifentanil was withdrawn 5 min before the operation completed.The hemodynamic indexes during and after the operation as well as the postoperative sedative degree of patients in the two groups were respectively observed.Results:No significant difference of hemodynamic indexes during the operation was observed between the two groups (P>0.05).No obvious difference was shown between the mean arterial pressure 5 min after removing tube in S group and the basic values;and a statistical difference was shown in R group (P<0.01).The Ramsay score of children in S group after operation was more appropriate,and VAS score was lower.Conclusions:Both sufentanil and remifentanil drugs can be good applied in pediatric tonsillectomy surgery.Sufentanil shows more advantages in improving the recovery quality and security of anesthesia after surgery.

       

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