本文選題：瑞芬太尼　切入點(diǎn)：七氟醚　出處：《世界最新醫(yī)學(xué)信息文摘》2016年54期

【摘要】：目的觀察瑞芬太尼聯(lián)合七氟醚復(fù)合麻醉用于小兒扁桃體和腺樣體切除時(shí)血流動(dòng)力學(xué)變化和意識(shí)恢復(fù)的情況。方法 asmⅠ或Ⅱ級(jí)擇期行扁桃體及腺體切除術(shù)的患兒88例,術(shù)前30min常規(guī)肌肉內(nèi)注射阿托品0.01mg,根據(jù)麻醉深淺調(diào)整泵注速度及七氟醚吸入濃度,維持循環(huán)穩(wěn)定。結(jié)果本組麻醉過程中各時(shí)點(diǎn)血壓變化差異無顯著性,但心率變化明顯。本組未用血管活性藥。停止麻醉藥至患兒呼吸回復(fù)時(shí)間為(3.2±1.1)min,至患兒意識(shí)恢復(fù)時(shí)間為(6.5±3.3)min,至完全清醒,同時(shí)拔出氣管時(shí)間為(11.6±8.1)min,術(shù)后無1例躁動(dòng)哭鬧,均能合作。術(shù)后發(fā)生劇烈疼痛6例,及中度疼痛20例,占29.5%;疼痛控制較滿意,發(fā)生惡心嘔吐5例,占5.7%。結(jié)論瑞芬太尼聯(lián)合七氟醚復(fù)合麻醉在麻醉誘導(dǎo)、氣管插管及術(shù)中各時(shí)點(diǎn)對(duì)心血管反應(yīng)較小,血流動(dòng)力學(xué)平穩(wěn),麻醉可控性強(qiáng),術(shù)后意識(shí)恢復(fù)迅速,完善;術(shù)后惡心嘔吐發(fā)生率低,能夠很好地滿足小兒扁桃體和腺體樣體切除的要求,值得在小兒手術(shù)麻醉中推廣應(yīng)用。
[Abstract]:Objective to observe the hemodynamic changes and recovery of consciousness during tonsillectomy and adenoidectomy in children with remifentanil combined with sevoflurane anesthesia. Preoperative 30min routine intramuscular injection of atropine 0.01mg. the pump injection speed and sevoflurane inhalation concentration were adjusted according to the depth of anesthesia to maintain stable circulation. Results there was no significant difference in blood pressure at different time points during anesthesia. But the change of heart rate was obvious. No vasoactive drugs were used in this group. The time of respiratory recovery was 3.2 鹵1.1 minutes, the recovery time of consciousness was 6.5 鹵3.3 minutes, and the time of trachea extraction was 11.6 鹵8.1 minutes. There was no restlessness and crying after operation, and the recovery time of consciousness was 6.5 鹵3.3 minutes, and the time of trachea extraction was 11.6 鹵8.1 minutes. There were 6 cases of severe pain, 20 cases of moderate pain, 5 cases of nausea and vomiting, 5 cases of nausea and vomiting, and 5 cases of nausea and vomiting. Conclusion remifentanil combined with sevoflurane combined anesthesia can induce anesthesia. Endotracheal intubation and each time point in operation had less cardiovascular response, stable hemodynamics, strong controllable anesthesia, rapid recovery of consciousness after operation, low incidence of nausea and vomiting, low incidence of postoperative nausea and vomiting, low incidence of nausea and vomiting, and low incidence of nausea and vomiting. It can satisfy the requirement of tonsillectomy and adenoid resection in children, and is worth popularizing in children's operation anesthesia.
【作者單位】： 山東省新泰市人民醫(yī)院手術(shù)麻醉科;
【分類號(hào)】：R726.1

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