郭文斌, 扬庆耿. 不同剂量瑞芬太尼对小儿七氟烷麻醉下自主呼吸的影响分析[J]. 蚌埠医科大学学报, 2016, 41(7): 879-881. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.013
    引用本文: 郭文斌, 扬庆耿. 不同剂量瑞芬太尼对小儿七氟烷麻醉下自主呼吸的影响分析[J]. 蚌埠医科大学学报, 2016, 41(7): 879-881. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.013
    GUO Wen-bin, YANG Qing-gen. Effect of different doses of remifentanil on the spontaneous respiration in children under the sevoflurane anesthesia[J]. Journal of Bengbu Medical University, 2016, 41(7): 879-881. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.013
    Citation: GUO Wen-bin, YANG Qing-gen. Effect of different doses of remifentanil on the spontaneous respiration in children under the sevoflurane anesthesia[J]. Journal of Bengbu Medical University, 2016, 41(7): 879-881. DOI: 10.13898/j.cnki.issn.1000-2200.2016.07.013

    不同剂量瑞芬太尼对小儿七氟烷麻醉下自主呼吸的影响分析

    Effect of different doses of remifentanil on the spontaneous respiration in children under the sevoflurane anesthesia

    • 摘要: 目的:探究不同剂量的瑞芬太尼对小儿七氟烷麻醉下自主呼吸的影响。方法:选取行腹股沟斜疝修补手术的小儿80例,根据使用瑞芬太尼剂量的不同分为低剂量组和高剂量组2组,各40例。低剂量组患儿应用0.03 μg·kg-1·min-1瑞芬太尼维持麻醉,高剂量组应用0.09 μg·kg-1·min-1瑞芬太尼。于喉罩置入后(T0)、静脉负荷量后(T1)、持续输注10min(T2)、持续输注15min(T3)及拔出喉罩时(T4)5个时点观察并记录2组患儿呼吸频率(RR)、潮气量(VT)、分钟通气量(MV)、呼气末CO2分压(PCO2)、平均动脉压(MBP)及心率(HR)各指标,同时统计术中缺氧血症的发生。结果:2组患儿的RR及MV均在麻醉T1时点出现显著下降,且低剂量组患儿T2、T3及T4时点的RR及MV均显著高于高剂量组(P<0.01)。2组患儿的PCO2在T1时点显著升高,且低剂量组患儿T2和T3 2个时点的PCO2显著低于高剂量组(P<0.01)。2组患儿各时点VT、HR及MBP的变化差异均无统计学意义(P>0.05)。2组患儿均未发生术中缺氧血症。结论:低剂量瑞芬太尼配合七氟烷在小儿保留自主呼吸麻醉中具有良好的麻醉效果,患儿呼吸系统更为稳定,具有临床应用价值。

       

      Abstract: Objective: To explore the clinical effects of different doses of remifentanil on the spontaneous respiration in children under the sevoflurane anesthesia.Methods: Eighty children treated with inguinal hernia repair operation were randomly divided into the low dose group and high dose group according to the use dose of remifentanil(40 cases each group).The anesthesia in low dose group and high dose group were maintained using 0.03μg·kg-1·min-1 and 0.09μg·kg-1·min-1 of remifentanil,respectively.The respiration rate(RR),tidal volume(TV),minute ventilation(MV),partial pressure of carbon dioxide in endexpiratory gas(PCO2),mean arterial pressure(MBP) and heart rate(HR) were recorded at T0(intubating laryngeal mask airway),T1(after intravenous loading),T2(after 10 min of anesthesia),T3(after 15 min of anesthesia) and T4(extracting laryngeal mask).The occurrence of intraoperative anoxenia in two groups were analyzed.Results: The levels of RR and MV in two groups significantly decreased at T1(P<0.01),and the levels of RR and MV in low dose group at T2,T3 and T4 were significantly higher than those in high dose group(P<0.01).The levels of PCO2 in two groups significantly increased at T1,and the levels of PCO2 in low dose group at T2 and T3 were significantly lower than those in high dose group(P<0.01).The differences of the level change of VT,HR and MBP in two groups at each time point were statistically significant(P>0.05).The intraoperative anoxenia was not found in two groups.Conclusions: The effect of sevoflurane combined with low dose remifentanil in spontaneous respiration anesthesia in children is good,which can make the respiratory system more stable in children,and has application value in clinic.

       

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