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目的探讨瑞芬太尼复合丙泊酚在小儿斜视手术中的应用效果和安全性。方法选择ASAⅠ~Ⅱ级,择期行小儿斜视手术患儿60例,随机分为瑞芬太尼复合丙泊酚(R组),氯胺酮复合丙泊酚组(K组),每组30例。观察并记录麻醉前(T0)、置入喉罩时(T1)、置入喉罩后5 min(T2)、拔喉罩前(T3)的心率(HR)和脉搏血氧饱和度(Sp O2)的变化,术后不良反应及苏醒时间。结果两组患儿年龄、性别、体重及手术时间比较差异无统计学意义(P>0.05),R组HR在T1、T2、T3三个时间点与T0相比较稳定,差异无统计学意义(P>0.05),与K组T1、T2、T3相比R组明显较低,差异有统计学意义(P<0.05)。K组HR在T1、T2、T3三个时间点与T0比较明显增快,差异有统计学意义(P<0.05)。两组患儿麻醉前后Sp O2比较,差异无统计学意义(P>0.05)。K组患儿术中呼吸道分泌物较多,置入喉罩时出现体动、屏气、呛咳病例明显多于R组(P<0.05)。结论在小儿斜视手术中采用瑞芬太尼复合丙泊酚麻醉,起效时间快,血流动力学稳定,苏醒迅速,可控性强。
Objective To investigate the effect and safety of remifentanil combined with propofol in pediatric strabismus surgery. Methods Sixty ASA Ⅰ ~ Ⅱ children with elective strabismus surgery were randomly divided into remifentanil combined with propofol (group R) and ketamine combined with propofol (group K), 30 cases in each group. The heart rate (HR) and pulse oxygen saturation (Sp O2) before anesthesia (T0), laryngeal mask placement (T1), laryngeal mask placement 5 min ) Changes, postoperative adverse reactions and recovery time. Results There was no significant difference in age, sex, body weight and operation time between the two groups (P> 0.05). The HR of R group was stable at T 1, T 2 and T 3, but the difference was not statistically significant P> 0.05). Compared with T1, T2 and T3 in group K, R group was significantly lower, the difference was statistically significant (P <0.05). The HR of K group was significantly higher than T0 at T1, T2 and T3 time points, the difference was statistically significant (P <0.05). There was no significant difference in Sp O2 between the two groups before and after anesthesia (P> 0.05). In group K, there were more respiratory secretions during operation. The body movement, breath holding and coughing were more obvious in group L than those in group R (P <0.05). Conclusion Remifentanil combined with propofol anesthesia in pediatric strabismus surgery, fast onset of time, hemodynamic stability, rapid recovery, strong controllability.