不同剂量芬太尼麻醉对小儿唇腭裂手术中平均动脉压及心率的影响Effect of Intravenous Anesthesia with Fentanyl at Different Doses on Hemodynamics of Children during Cleft Lip and Palate Repair Surgery
姚茵,王一君
YAO Yin,WANG Yijun
摘要(Abstract):
目的:研究不同剂量芬太尼麻醉对小儿唇腭裂手术患儿血流动力学参数及苏醒过程的影响。方法:随机选取60例先天性唇腭裂手术患儿,平均分为A、B、C三组,每组20例,分别给予芬太尼3、5、7μg/kg,观察患儿心率(HR)、平均动脉压(MAP)、苏醒时间以及嗜睡、躁动、恶心呕吐等不良反应情况。结果:3组中,B组患儿在麻醉过程中血流动力学参数(HR和MAP)最稳定,不同时点间差异无统计学意义(P<0.05);B组患儿苏醒时间平均(18.9±5.6)min,居A、C两组之间,不良反应较少,其中嗜睡1例,躁动2例,恶心呕吐病例1例。结论:小儿唇腭裂手术麻醉诱导时用5μg/kg剂量的芬太尼,可以维持稳定的血流动力学,更安全。
Objective: To study the effects of intravenous anesthesia with fentanyl at different doses on hemodynamics and recovery time of children accepting cleft lip and palate repair surgery. Methods:Sixty children accepting cleft lip and palate repair surgery were randomly divided into groups A,B and C and were given 3,5,7 μg / kg fentanyl respectively. Heart rate( HR),mean arterial pressure( MAP),recovery time and adverse reaction including drowsiness,restlessness,nausea and vomiting were observed. Results: Children in group B had the most stable hemodynamic parameters,there was no significant difference among different time points( P < 0. 05). The recovery time in B group was( 18. 9 ± 5. 6) min,which was longer than that in group B and shorter than group C. Adverse reaction in group B was less,1 case with drowsiness,2 cases with restlessness and 1 case with nausea and vomiting. Conclusion: Intravenous anesthesia using 5 μg / kg fentanyl in children with cleft lip and palate repair surgery can provide stable hemodynamics and is safe.
关键词(KeyWords):
芬太尼;麻醉,静脉;唇裂;鄂裂;儿童;剂量效应关系,药物
fentanyl;anesthesia,intravenous;cleft lip;cleft palate;child;dose-response relationship,drug
基金项目(Foundation):
作者(Author):
姚茵,王一君
YAO Yin,WANG Yijun
DOI: 10.19367/j.cnki.1000-2707.2015.02.016
参考文献(References):
- [1]范有勤,代红梅.瑞芬尼在小儿唇腭裂修补术中的应用[J].中国美容医学,2010(11):1625-1626.
- [2]丁耀茂,林红,丁伟.舒芬太尼、瑞芬太尼、芬太尼对全麻患者气管插管时心血管反应的影响[J].现代医院,2010(10):28-30.
- [3]刘鲲鹏,薛富善.小剂量芬太尼、瑞芬太尼和舒芬太尼预防儿童经口气管插管心血管反应的比较[J].实用儿科临床杂志,2007(22):391-394.
- [4]庄心良,陈伯銮,曾因明.现代麻醉学[M].3版.北京人民卫生出版社,2003:522-523.
- [5]Claeys MA,Gepts E,Camu F.Haemodynamic changes during anaesthesia induced and manintained with propofol[J].Br J Anaesth,1988(60):3.
- [6]高峰,杨辉.不同药物治疗全麻患者苏醒期躁动的疗效比较[J].临床麻醉学杂志,2011(2):109-111
- [7]Reves JG.Educational considerations for the clinical introduction and use of remifentanil[J].Anesth Analg,1999(89):7-14.
- [8]Milic'M,Goranovic'T,Knezevic'P.complications of sevoflurane-fentanyl versus midazolam-fentanyl anesthesia in pediatric cleft lip and palate surgery:a randomized comparison study[J].Int J Oral Maxilofac Surg,2010(39):5-9.
文章评论(Comment):
|
||||||||||||||||||
|
- 芬太尼
- 麻醉,静脉
- 唇裂
- 鄂裂
- 儿童
- 剂量效应关系,药物
fentanyl - anesthesia,intravenous
- cleft lip
- cleft palate
- child
- dose-response relationship,drug