本文選題：全憑靜脈麻醉 + 小兒�。� 參考：《武警后勤學(xué)院學(xué)報(醫(yī)學(xué)版)》2016年02期

【摘要】：【目的】觀察兩種全憑靜脈麻醉方法在小兒鼻淚道手術(shù)的臨床應(yīng)用效果。【方法】選100例行內(nèi)窺鏡下鼻淚道手術(shù)的小兒(1.5~6歲),依據(jù)美國麻醉醫(yī)師協(xié)會(american society of anesthesiologists,ASA)分級標(biāo)準(zhǔn)隨機(jī)分為A、B兩組(n=50),A組誘導(dǎo)前靜脈泵注右旋美托咪啶[初始量0.6μg·(kg·h)-1,10 min],術(shù)中靶控靜脈泵注右旋美托咪啶0.5μg·(kg·h)-1及雷米芬太尼,B組常規(guī)誘導(dǎo)后靶控靜脈泵注丙泊酚和雷米芬太尼,術(shù)畢前5 min停用麻醉藥物。術(shù)中根據(jù)腦電雙頻譜指數(shù)(bispectral index,BIS)調(diào)整麻醉藥用量。記錄和測定麻醉誘導(dǎo)前(T0)、氣管插管即刻(T1)、置入鼻內(nèi)窺鏡時(T2)、拔管后1 min(T3)、3 min(T4)的平均動脈壓(mean arterial pressure,MAP)、心率(heart rate,HR)、去甲腎上腺素(norepinephrine,NE)、腎上腺素(epinephrine,E)的變化和術(shù)中雷米芬太尼用量、麻醉恢復(fù)時間及不良反應(yīng)�！窘Y(jié)果】與B組相比,A組T0、T1、T2、T3時MAP、HR、血漿NE、E濃度下降明顯(P0.05);與T0相比,B組T1、T3時HR、MAP及血漿NE和E濃度均顯著升高(P0.05);雷米芬太尼總用藥量A組顯著少于B組(P0.05)。A組術(shù)后拔管后氣道痙攣、術(shù)后頭疼、呼吸抑制、嗆咳躁動發(fā)生率也明顯低于B組(P0.05)�！窘Y(jié)論】右旋美托咪啶復(fù)合雷米芬太尼的全憑靜脈麻醉方法可減輕小兒鼻淚道手術(shù)應(yīng)激反應(yīng)及術(shù)后不良反應(yīng)、減少麻醉藥用量,但不延長麻醉蘇醒時間。
[Abstract]:[objective] to observe the clinical effect of two total intravenous anaesthesia methods in pediatric nasolacrimal duct surgery. [methods] 100 children undergoing endoscopic nasolacrimal duct surgery were enrolled in this study. According to the score of American society of the anesthesiologists ASAs, 100 children with nasolacrimal duct surgery underwent endoscopic nasolacrimal surgery. The first grade standard was randomly divided into two groups: group A (n = 50) received dexmetidine before induction [initial dose was 0.6 渭 g / kg / h ~ (-1) 10 min], target controlled intravenous injection of dexmetidine 0.5 渭 g / kg / h ~ (-1) and remifentanil group B (n = 10) were treated with propofol and remifentanil after conventional induction. The anesthetic was stopped 5 min before the end of operation. The dosage of anesthetic was adjusted according to bispectral index (BIS). The mean arterial pressureMAPP, heart rate, norepinephrine, epinephrine (epinephrine) and the dosage of ramifentanil were recorded and measured before anesthesia induction, immediately after endotracheal intubation, 1 min after extubation and 1 min after extubation. Anesthesia recovery time and adverse reactions. [results] compared with group B, MAPHRs of T0 and T1 and T2T3 of group A decreased significantly (P 0.05), HRMAP, NE and E of plasma of group B were significantly higher than those of group T0; total dosage of remifentanil was significantly increased in group A. The airway spasm after extubation in group B was significantly less than that in group B (P 0.05). The incidence of headache, respiratory inhibition, cough and restlessness in group B was significantly lower than that in group B. [conclusion] the total intravenous anesthesia of dexmetidine combined with remifentanil can relieve the stress reaction and postoperative adverse reactions of nasolacrimal duct surgery in children. Reduce the amount of anesthetic, but do not prolong the anaesthesia recovery time.
【作者單位】： 沈陽市第四人民醫(yī)院麻醉科;中國醫(yī)科大學(xué)附屬盛京醫(yī)院麻醉科;
【分類號】：R726.1

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 唐啟鵬;特重度燒傷病人應(yīng)用兩組不同靜脈麻醉方法的比較[J];浙江創(chuàng)傷外科;2004年04期

2 楊光平;溫漢新;曹殿青;蔡偉華;揭育麗;;不同靜脈麻醉方法對開胸手術(shù)應(yīng)激反應(yīng)的影響[J];廣東醫(yī)學(xué);2007年08期

3 陳驍俊,潘云;兩種靜脈麻醉方法用于宮腔鏡手術(shù)的臨床對比觀察[J];杭州醫(yī)學(xué)高等專科學(xué)校學(xué)報;2003年03期

4 翁劍武,黑子清;兩種靜脈麻醉方法用于小兒支撐喉鏡下手術(shù)比較[J];廣東醫(yī)學(xué);2000年08期

5 劉樹民;李辛潔;葉玉軍;;不同靜脈麻醉方法在婦科門診手術(shù)中的應(yīng)用[J];山東醫(yī)藥;2010年14期

6 齊文斌;;兩種靜脈麻醉方法在三叉神經(jīng)節(jié)射頻熱凝術(shù)中的應(yīng)用觀察[J];中國實用醫(yī)藥;2011年35期

7 楊云;;靶控輸注在經(jīng)腹腔鏡膽囊切除術(shù)中的應(yīng)用[J];北方藥學(xué);2013年04期

8 段波,陳葒;3種人工流產(chǎn)靜脈麻醉方法的臨床觀察[J];重慶醫(yī)學(xué);2005年10期

9 羅志平;;丙泊酚、芬太尼兩種靜脈麻醉方法在人工流產(chǎn)中的臨床觀察[J];中國醫(yī)學(xué)創(chuàng)新;2008年31期

10 何咸兵;周斌;李志輝;王品;孫浩;趙建生;;乳腺癌改良根治術(shù)中瑞芬太尼復(fù)合丙泊酚全憑靜脈麻醉方法的探討[J];臨床腫瘤學(xué)雜志;2008年08期

，

本文編號：1861671