舒芬太尼与瑞芬太尼用于小儿咽喉部手术麻醉的比较(1)
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[摘要] 目的：观察舒芬太尼与瑞芬太尼在小儿咽喉部手术术中及术后的镇痛和镇静作用。方法：选择择期进行咽喉部手术的患儿100例，随机分为舒芬太尼组(S组，n=50)和瑞芬太尼组(R组，n=50)。S组以舒芬太尼0.2 μg/kg快速诱导，以0.2 μg/(kg·h)术中维持，手术结束前30 min停药。R组以瑞芬太尼2 μg/kg快速诱导，以6 μg/(kg·h)术中维持，手术结束前5 min停药。分别观察两组术中、术后血流动力学指标及术后患儿镇痛和镇静程度。结果：两组术中血流动力学指标无显著性差异(P>0.05)。拔管后5 min时S组平均动脉压(MAP)较基础值无显著性差异；R组MAP较基础值明显增高(P<0.05)。S组患儿术后Ramsay评分较适宜，VAS评分较低。结论：两种药物均能较好地用于小儿咽喉部手术，舒芬太尼在提高术后麻醉恢复质量上和手术安全性上更有优势。
[关键词] 咽喉部手术；瑞芬太尼；舒芬太尼；麻醉
[中图分类号] R614[文献标识码]A [文章编号]1673-7210(2009)01(c)-010-02
Comparison of Sufentanil and Remifentanil in the anesthesia of children throat surgery
LIU Kun
(The First People's Hospital of Anesthesia, Shangqiu City, Henan Province, Shangqiu476000, China)
[Abstract] Objective: To observe the analgesic and sedative effects of Sufentanil and Remifentanil in children throat surgery and after the surgery. Methods: 100 patients involved with selective operation were chosen and randomly divided into two groups: Sufentanil group (S group, n=50) and Remifentanil group (R group, n=50). Patients in S group were rapidly induced by 0.2 μg/kg Sufentanil, and were maintained with 0.2 μg/(kg·h) in the operation. Sufentanil was withdrawn 30 min before the operation completed. Patients in R group were rapidly induced by 2 μg/kg Remifentanil, and were maintained with 6 μg/(kg·h) in the operation. Remifentanil was withdrawn 5 min before the operation completed. The hemodynamic indexes during and after the operation as well as the postoperative sedative degree of patients in the two groups were respectively observed Results: No significant difference of hemodynamic indexes during the operation was observed between the two groups(P>0.05). No obvious difference was shown between the mean arterial pressure (MAP) 5 min after removing tube in S group and the basic values; and a statistical difference was shown in R group (P<0.05). The Ramsay score of children in S group after operation was more appropriate, and VAS score was lower. Conclusion: Both drugs can be better applied in children throat surgery. Sufentanil shows more advantages in improving the recovery quality and security of anesthesia after surgery ......
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