摘要
目的比较丙泊酚联合瑞芬太尼不同剂量的配伍方案用于小儿无肌松气管插管中的临床效果,寻求最佳剂量配伍方案。方法选择小儿外科住院患儿180例,择期行腹腔镜疝气修补术,1岁-3岁,ASAⅠ-Ⅱ级。麻醉诱导方案中设定丙泊酚2.5/3/3.5mg/kg三个剂量与瑞芬太尼2.5/3/4μg/kg三个剂量进行两两组合,随机分成9个组剂量组(A-I),每组20例。所有患儿均实施无肌松插管静脉全麻,每组患儿麻醉诱导时统一先给予丙泊酚,待患儿入睡,睫毛反射消失后再缓慢给予瑞芬太尼,下颌松弛后进行无肌松气管插管,并观察插管条件及插管前后的血流动力学波动,对试验过程中不良反应的发生率进行分析比较。结果采用丙泊酚3mg/kg联合瑞芬太尼3μg/kg进行无肌松气管插管时效果最佳,插管前后血流动力学最稳定,无明显不良反应。结论在1岁-3岁小儿无肌松气管插管全麻中,丙泊酚3mg/kg联合瑞芬太尼3μg/kg是麻醉诱导的最佳剂量配伍方案。
Objective To compare the clinical effects of different dosage of propofol combined with remifentanil in the endotracheal intubation without muscle relaxants,and to seek the best dosage.Methods A total of 180 pediatric hospitalized children undergoing surgery were selected for the trial,aged 1-3 years with the ASA physical statusⅠorⅡ.In the anesthesia induction scheme,three doses of propofol(2.5mg/kg、3 mg/kg、3.5 mg/kg)and three doses of remifentanil(2.5μg/kg、3μg/kg、4μg/kg)were combined in pairs and randomly divided into 9 dose groups(A-I),with 20 cases in each group.All children were endotracheal intubated without muscle relaxants.The children in each group were given propofol at the time of anesthesia induction,and remifentanil was slowly given after the children fell asleep and the eyelash reflexes disappeared.After the mandibular relaxation,the children were intubated without muscle relaxants.The conditions of intubation and the hemodynamic fluctuations before and after intubation were observed,and the incidence of adverse reactions during the trial was analyzed and compared.Results Propofol 3 mg/kg combined with remifentanil 3μg/kg was the best method for intubation without muscle.The hemodynamics was the most stable Before and after intubation,and there was no obvious adverse reaction.Conclusion Propofol 3 mg/kg combined with remifentanil 3μg/kg was the Optimum dose combination for the endotracheal intubation without muscle relaxants in children aged 1-3 years.
作者
谭美云
曾伟
白彩霞
张春元
TAN Meiyun;ZENG Wei;BAI Caixia;ZHANG Chunyuan(Department of Anesthesiology,Boai Hospital of Zhongshan,Zhongshan,528400,Guangdong,China)
出处
《新疆医学》
2022年第11期1298-1301,1319,共5页
Xinjiang Medical Journal
基金
中山市社会公益与基础研究项目(项目编号:2021SYF01)
关键词
丙泊酚
瑞芬太尼
最佳剂量组合
无肌松气管插管
Propofol
Remifentanil
Optimal dose combination
Intubation without muscle relaxants
作者简介
谭美云,女,硕士,主治医师,研究方向:小儿麻醉;通信作者:张春元,男,硕士,主任医师,研究方向:妇产科与小儿麻醉,E-mail:zhangchunyuan88888@163.com。