丙泊酚分别复合芬太尼、舒芬太尼在喉罩通气下小儿日间腹股沟斜疝手术麻醉中的效果对比
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摘要
目的:对比丙泊酚分别复合芬太尼、舒芬太尼在喉罩通气下小儿日间腹股沟斜疝手术麻醉中的效果。方法:选取2016年10月-2018年10月于本院手术的腹股沟斜疝患儿82例,参照奇偶数法将患儿随机分成F组(以芬太尼进行麻醉)和S组(以舒芬太尼进行麻醉),各41例。对比两组麻醉效果、对生命体征的影响及不良事件。结果:S组的苏醒时间、麻醉诱导时间均短于F组,躁动评分低于F组,Ramsay镇静评分高于F组(P<0.05);F组T1、T2时平均动脉压(MAP)和心率(HR)均高于T0时,且均高于S组同一时间点的水平(P<0.05),而S组麻醉不同时间点的MAP和HR比较,差异均无统计学意义(P>0.05);S组术中体动、注射部位疼痛和术后躁动发生率均低于F组(P<0.05)。结论:舒芬太尼在小儿腹股沟斜疝手术中能达到更好的麻醉效果,药效发挥和患儿苏醒均较快,且能减轻患儿躁动和生命体征的波动,用药安全性较高。
Objective:To compare the effects of Propofol combined with Fentanyl and Sufentanil in anesthesia of children with inguinal hernia during laryngeal mask ventilation.Method:82 children with inguinal hernia operated from October 2016 to October 2018 in our hospital were selected,they were randomly divided into group F(anesthesia with Fentanyl)and group S(anesthesia with Sufentanil),with 41 cases in each group.The the effects of anesthesia,the impact on vital signs and adverse events in two groups were compared.Result:The awaking time and anesthesia induction time of group S were shorter than those of group F,the score of agitation was lower than that of group F,and the score of Ramsay sedation score was higher than that of group F(P<0.05).Average arterial pressure(MAP)and heart rate(HR)in group F at T1 and T2 were higher than those at T0,and both were higher than those at the same time point in group S(P<0.05).Comparison of MAP and HR at different time points of anesthesia in group S showed no statistically significant difference(P>0.05).The incidence of intraoperative motion,injection site pain and postoperative agitation in group S were lower than those in group F(P<0.05).Conclusion:Sufentanil can achieve better anesthesia effect in operation of inguinal hernia,the efficacy of drug and wakefulness are faster,and it can alleviate the agitation and fluctuation of vital signs and the medication safety is higher.
Objective:To compare the effects of Propofol combined with Fentanyl and Sufentanil in anesthesia of children with inguinal hernia during laryngeal mask ventilation.Method:82 children with inguinal hernia operated from October 2016 to October 2018 in our hospital were selected,they were randomly divided into group F(anesthesia with Fentanyl)and group S(anesthesia with Sufentanil),with 41 cases in each group.The the effects of anesthesia,the impact on vital signs and adverse events in two groups were compared.Result:The awaking time and anesthesia induction time of group S were shorter than those of group F,the score of agitation was lower than that of group F,and the score of Ramsay sedation score was higher than that of group F(P<0.05).Average arterial pressure(MAP)and heart rate(HR)in group F at T1 and T2 were higher than those at T0,and both were higher than those at the same time point in group S(P<0.05).Comparison of MAP and HR at different time points of anesthesia in group S showed no statistically significant difference(P>0.05).The incidence of intraoperative motion,injection site pain and postoperative agitation in group S were lower than those in group F(P<0.05).Conclusion:Sufentanil can achieve better anesthesia effect in operation of inguinal hernia,the efficacy of drug and wakefulness are faster,and it can alleviate the agitation and fluctuation of vital signs and the medication safety is higher.
引文
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[7]邹鑫,刘志林,范文杰,等.丙泊酚联合舒芬太尼静脉麻醉在小儿无痛结肠镜手术中的应用[J].医学临床研究,2018,35(4):794-796.
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[9]黄卫忠,林家善,钟霓.七氟烷和丙泊酚分别联合舒芬太尼静脉麻醉在小儿腹腔镜疝气修复术中的效果对比[J].海峡药学,2018,30(6):165-167.
[10]王建设,赵龙德,费建.舒芬太尼在儿童全麻肠镜检查中的临床应用[J].中国内镜杂志,2017,23(5):44-48.
[11]袁华平,刘艳军,陈春,等.七氟烷和丙泊酚麻醉对体外循环脑氧代谢及术后认知功能的比较[J].医药导报,2016,35(4):349-352.
[12]冷福建,乐林莉,李娜,等.等效剂量的舒芬太尼和芬太尼用于小儿腹腔镜下疝囊高位结扎术中的比较[J].实用医学杂志,2015,31(21):3632-3633.
[13]李立,刘金东,张奉超,等.喉罩通气下吸入地氟醚麻醉维持在婴幼儿颜面部混合血管瘤介入手术中的应用[J].局解手术学杂志,2018,150(5):64-67.
[14]戴珩,颜娅,李有长.曲马多、舒芬太尼分别与丙泊酚联合在宫腔镜手术静脉麻醉诱导中的应用效果对比观察[J].山东医药,2018,58(19):59-61.
[15]秦革萍,杜睿,石小龙,等.盐酸右美托咪啶复合舒芬太尼用于小儿术后镇痛的疗效观察[J].医药论坛杂志,2017,38(12):144-145.
[16]刘晶晶,安频,朱诗利,等.舒芬太尼减轻小儿全麻苏醒期躁动的临床观察[J].临床小儿外科杂志,2016,15(2):196-198.
[17]卓海珍.盐酸右美托咪啶联合舒芬太尼在小儿肛门直肠畸形术后镇痛镇静的应用[J].结直肠肛门外科,2017,23(1):52-56.
[18]曾小华.小儿神经外科手术麻醉中舒芬太尼应用的价值分析[J].中西医结合心血管病杂志,2017,5(24):24.
[19]郑淑凤,陈惠芳,汤昌明,等.舒芬太尼预防小儿脑瘫矫形术围拔管期躁动的临床研究[J].中外医学研究,2017,15(33):177-179.
[20]王建设,费建,赵龙德.芬太尼与舒芬太尼在小儿日间手术腹股沟斜疝麻醉中的效果比较[J].中国现代医学杂志,2017,27(5):78-81.
[2]莫涛,张奉超.右美托咪定和丙泊酚分别复合瑞芬太尼在小儿麻醉中维持喉罩通气的临床效果比较[J].医学临床研究,2018,35(2):391-393.
[3]蒋文军,张敏,张远,等.七氟烷联合舒芬太尼注射液在小儿腹股沟斜疝腹腔镜手术中的麻醉效果[J].中国临床药理学杂志,2017,33(16):1534-1536.
[4]吴华苗,张永年,徐小想.七氟烷复合舒芬太尼静脉麻醉在小儿腹腔镜疝气修复术中的应用[J].海南医学,2016,27(24):4097-4099.
[5]陈伟,苏小虎,饶丽华,等.舒芬太尼复合七氟烷麻醉在小儿扁桃体或联合腺样体切除术中的应用[J].中国新药与临床杂志,2015,34(1):40-43.
[6]孟丽,隆全利,蒙国光,等.舒芬太尼复合静脉麻醉在小儿泌尿外科手术中的应用[J].医学临床研究,2017,34(1):115-116.
[7]邹鑫,刘志林,范文杰,等.丙泊酚联合舒芬太尼静脉麻醉在小儿无痛结肠镜手术中的应用[J].医学临床研究,2018,35(4):794-796.
[8]李朝玉,段满林.舒芬太尼诱导全身麻醉对患者血流动力学的影响[J].海南医学院学报,2015,21(3):406-408.
[9]黄卫忠,林家善,钟霓.七氟烷和丙泊酚分别联合舒芬太尼静脉麻醉在小儿腹腔镜疝气修复术中的效果对比[J].海峡药学,2018,30(6):165-167.
[10]王建设,赵龙德,费建.舒芬太尼在儿童全麻肠镜检查中的临床应用[J].中国内镜杂志,2017,23(5):44-48.
[11]袁华平,刘艳军,陈春,等.七氟烷和丙泊酚麻醉对体外循环脑氧代谢及术后认知功能的比较[J].医药导报,2016,35(4):349-352.
[12]冷福建,乐林莉,李娜,等.等效剂量的舒芬太尼和芬太尼用于小儿腹腔镜下疝囊高位结扎术中的比较[J].实用医学杂志,2015,31(21):3632-3633.
[13]李立,刘金东,张奉超,等.喉罩通气下吸入地氟醚麻醉维持在婴幼儿颜面部混合血管瘤介入手术中的应用[J].局解手术学杂志,2018,150(5):64-67.
[14]戴珩,颜娅,李有长.曲马多、舒芬太尼分别与丙泊酚联合在宫腔镜手术静脉麻醉诱导中的应用效果对比观察[J].山东医药,2018,58(19):59-61.
[15]秦革萍,杜睿,石小龙,等.盐酸右美托咪啶复合舒芬太尼用于小儿术后镇痛的疗效观察[J].医药论坛杂志,2017,38(12):144-145.
[16]刘晶晶,安频,朱诗利,等.舒芬太尼减轻小儿全麻苏醒期躁动的临床观察[J].临床小儿外科杂志,2016,15(2):196-198.
[17]卓海珍.盐酸右美托咪啶联合舒芬太尼在小儿肛门直肠畸形术后镇痛镇静的应用[J].结直肠肛门外科,2017,23(1):52-56.
[18]曾小华.小儿神经外科手术麻醉中舒芬太尼应用的价值分析[J].中西医结合心血管病杂志,2017,5(24):24.
[19]郑淑凤,陈惠芳,汤昌明,等.舒芬太尼预防小儿脑瘫矫形术围拔管期躁动的临床研究[J].中外医学研究,2017,15(33):177-179.
[20]王建设,费建,赵龙德.芬太尼与舒芬太尼在小儿日间手术腹股沟斜疝麻醉中的效果比较[J].中国现代医学杂志,2017,27(5):78-81.