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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。
Objective: To investigate the clinical effects of different concentrations of propofol combined with remifentanil target controlled infusion laryngeal mask anesthesia in pediatric short operation. Methods: A total of 127 children treated with short-term surgery were divided into two groups according to the target concentration of propofol: group A (2 ng / mL), group B (3 ng / mL) and group C (4 ng / mL) In combination with remifentanil 2 ng / mL target-controlled infusion, laryngeal mask placement, failed to gradually increase the dose of remifentanil 0.5 ng / mL until successful implantation. The children with the highest power of each group were divided into A1, B1 and C1. The incidences of adverse reactions in the three subgroups were compared, as well as HR, BIS and MAP in each time period. Results: The successful rate was highest at 3 ng / mL, 2.5 ng / mL and 2 ng / mL in group A, group B and group C respectively, with the highest satisfaction / acceptable ratio, and the difference with other concentrations was Statistical significance (P <0.05). The satisfaction / acceptable ratio of group B1 was higher than that of group A1 and group C1 (x2 = 5.189, x2 = 7.031, P <0.05). The incidence of adverse reactions was the highest in A1 group, followed by C1 group, which was significantly different from that in B1 group (P <0.05). Analysis of variance within the group showed that the A1 group and the C1 group fluctuated with a significant difference (P <0.05), while the B1 group was generally stable with no significant difference (P> 0.05). Conclusion: The application of 2.5 ng / mL remifentanil and 3 ng / mL propofol target controlled infusion in the short-term operation of pediatric laryngeal anesthesia is the best, the clinical indicators are stable and the incidence of adverse reactions is low.