| 张生长 王世祥 王福生 陈玉培 刘晓军.丙泊酚联合瑞芬太尼靶控输注在小儿短小手术中的效果分析[J].,2015,15(23):4537-4540 |
| 丙泊酚联合瑞芬太尼靶控输注在小儿短小手术中的效果分析 |
| Analysis of Infusion in Pediatric Short Operation Effect ofPropofol Combined with Remifentanil Target Controlled |
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| DOI： |
| 中文关键词: 靶控输注 喉罩麻醉 瑞芬太尼 丙泊酚 |
| 英文关键词: Target controlled infusion Laryngeal mask anesthesia Remifentanil Propofol |
| 基金项目:卫生部医药卫生科技发展研究中心基金课题（W2013R39） |
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| 中文摘要: |
| 目的：探讨不同浓度丙泊酚联合瑞芬太尼靶控输注喉罩麻醉在小儿短小手术中的临床效果。方法：127 例采用小儿短小手
术治疗的患儿按丙泊酚给药目标浓度分为A 组(2 ng/mL)、B 组(3 ng/mL)和C 组(4 ng/mL)，分别与瑞芬太尼2 ng/mL联合应用靶
控输注，行喉罩置入，失败则逐次增加瑞芬太尼剂量0.5 ng/mL直至成功置入。将各组成功率最高时浓度下的患儿分为A1、B1 和
C1，比较三个亚组不良反应发生情况、以及各时段HR、BIS 值和MAP。结果：A 组、B 组和C 组患儿中分别在3 ng/mL、2.5 ng/mL
和2 ng/mL时置入成功率最高，满意/ 可接受比也最高，与其它浓度比较差异有统计学意义（P<0.05）。B1 组满意/ 可接受比值高
于A1 组和C1组，差异有统计学意义（x2=5.189, x2=7.031, P<0.05)。不良反应发生率A1 组最高，其次是C1 组，与B1 组比较差异
均有统计学意义(P<0.05)。组内行方差分析发现，A1 组和C1 组有较大波动，差异有统计学意义(P<0.05)，而B1 组总体平稳，差异
无统计学意义(P>0.05)。结论：2.5 ng/mL瑞芬太尼与3 ng/mL丙泊酚靶控输注时喉罩麻醉在小儿短小手术中的应用效果最好，各
临床指标较为平稳，不良反应发生率低。 |
| 英文摘要: |
| Objective:To evaluate the clinical effects of different doses of propofol combined with remifentanil target controlled
infusion of laryngeal mask anesthesia in paediatric.Methods:127 cases were divided into groupA (2 ng/mL), groupB (3 ng/mL) and
groupC (4 ng/mL) by target concentration of propofol, combined with remifentanil (2 ng/mL) target controlled infusion, increased
stepwise by 0.5 ng/mL until a successful insertion of LMA. The remifentanil concentration was recorded when LMA was successfully
inserted and the cases were numerated at each remifentanil concentration. The highest success rate when the concentration of each group
were divided into A1, B1 and C1, the incidence of adverse reactions, and each time HR, BIS and MAP of each group were compared.Results:When the concentration was 3 ng/mL, 2.5 ng/mL and 2 ng/mL, respectively, Group A, group B and group C had the highest
success rate, and the highest good/acceptable ratio; differences were statistically significant when compared with other concentrations
(P<0.05). The satisfaction/acceptable ratio of group B1 was higher than those of group A1 and group C1, with statistical difference (x2=5.
189, x2=7.031, P<0.05). The group A1 had the highest incidence of adverse reactions, followed by group C1, and all the differences were
statistically significant when compared with group B1 (P<0.05). The variance analysis intra group found that group A1 and group C1 had
larger fluctuation, with statistically significant difference (P<0.05), while group B1 showed overall smooth with no significant difference
(P>0.05).Conclusion:Remifentanil in 2.5 ng/mL and Propofol in 3 ng/mL with target controlled infusion could achieve the best effect on
children in laryngeal mask anesthesia, with low adverse reactions incidence. |
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