不同麻醉维持方式对小儿 OSAS手术后苏醒期躁动影响比较-论文.pdf

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1、·446·2014年9月第32卷第5期JHuaihaiMed，September2014，Vo1．32N0．5不同麻醉维持方式对小儿OSAS手术后苏醒期躁动影响比较张坤鹏【摘要】目的探讨瑞芬太尼复合异丙酚全凭静脉麻醉与瑞芬太尼复合七氟醚静吸复合麻醉对阻塞性睡眠呼吸暂停综合征(OSAS)惠儿苏醒期躁动(EA)的影响。方法选择40例4～11岁择期行扁桃体切除和(或)腺样体刮除手术的患儿，随机分为全凭静脉麻醉(I)组与静吸复合麻醉组(S)组，每组20例。2组均以咪唑安定0．1mg／kg，瑞芬太尼1tLg／kg，异丙酚1．5～

2、2mg／kg，和罗库溴铵0．6mg／kg麻醉诱导插管，I组麻醉维持应用瑞芬太尼0．4—0．5txg‘kg-。·min+异丙酚4～6mg·kg～·h-。，手术结束同时停止输注。s组麻醉维持以瑞芬太尼0．4～0．5Ixg·kg·rain+吸入七氟醚1．2～1．8MAC，手术结束同时停药。EA按照5点法进行评估。结果I组EA评分平均低于S组(P<0．05)，EA发生率(25％)明显低于s组(60％)。结论OSAS手术患儿瑞芬太尼异丙酚全凭静脉麻醉后EA的发生率低于七氟醚异丙酚静吸复合麻醉。【关键词】异丙酚；七氟醚；瑞芬太尼；

3、全凭静脉麻醉；静吸复合麻醉；苏醒期躁动【中图分类号】R614【文献标识码】A【文章编号】1008-7044(2014)05-0446-02EfectofdiferentanesthesiamaintenancemodesonchildrenemergenceagitationafterOSASsurgery：astudyofcomparisonZHANGKun-peng．(TheGeneralHospitalofCoalMiners，Huaibei，Anhui235000，China)【Abstract】Objecti

4、veTocomparetheeffectofremifentanil—propofoltotalintravenousanesthesiaandremifentanil—sevofluraneinhalation．intravenousbalancedanesthesiaoveremergenceagitation(EA)ofchildrenwithobstructivesleepapneasyndrome(OSAS)duringanesthesiarecovery．Methods40childrenaged4to11

5、yearsoldundergoingselectivetonsillectomyand(or)adenoidectomywereallocatedrandomlyintotwogroups(20caseseach)：thetotalintravenousanesthesiagroup(Igroup)andtheinhalation—intravenousbMancedanesthesiagroup(Sgroup)．Theinducedanesthesiawasperformedwithmid—azolam0．1mg／k

6、g，remifentanil1kg，propofol1．5～2mg／kg，androcuronium0．6mg／kginbothgroups．Anesthesiawasmaintainedas~llows：inIgroupwithremifentanil0．4～0．5txg·kg一·min一propofol4～6mg·kg一·h一；inSgroupwithremi~ntanil0．4～0．5g·kg一·min一+sevoflurane1．2～1．8MAC．Theanesthesiawaswithdrawnsimulta

7、neouslybytheendofoperation．5pointmethodwasusedtoassessEA．InIgroup，theaverageEAscorewaslowerthanthatinSgroup(P<0．05)；theincidencerateofEA(25％)wassignificantlylowerthanthatinSgroup(60％)．ConclusionThebalancedanesthesiacanreducetheincidencerateofEAofOSASsurgerydurin

8、ganesthesiarecoveryinchildrenthanthetotalintrave—nousanesthesia．【Keywords】Propofol；Sevoflurane；Remifentanil；Totalintravenousanesthesia；Inhalation—intravenousbalanceda