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目的:探究小儿七氟烷麻醉中不同剂量瑞芬太尼持续输注下自主呼吸情况,为今后临床治疗提供可靠的经验。方法:随机选取180例行腹股沟斜疝修补术的患儿,将其分为甲、乙、丙组,每组各60例患儿。甲组(低剂量组)给予0.03μg/kg~(-1)瑞芬太尼,乙组(中剂量组)给予0.06μg/kg-1~(-1)瑞芬太尼,丙组(高剂量组)给予0.09μg/kg~(-1)瑞芬太尼。观察三组患儿的呼吸抑制情况,包括呼吸频率(RR),每分通气量(MV)潮气量(VT);观察患儿喉罩置入后(A),静脉输注瑞芬太尼负荷量后(B),持续输注10min后(C),持续输注15min后(D),拔出喉罩时(E)。结果:三组不同时刻RR对比,A、B时三组间未见显著性差异P>0.05,在C、D、E时甲组、乙组明显高于丙组(P<0.05),且甲、乙组间差异无统计学意义P>0.05。各组间的不同时刻VT相比均未有显著性差异P>0.05。三组间不同时刻MV对比在A、B时三组间未见显著性差异(P>0.05),C、D、E丙组MV明显低于甲、乙组(P<0.05),甲、乙两组间无差异(P>0.05)。结论:小儿七氟烷麻醉中较低浓度瑞芬太尼可减少对呼吸的抑制作用,尽量保留了患儿的自主呼吸,安全性更高。
Objective: To study the spontaneous respiration of different doses of remifentanil in pediatric sevoflurane anesthesia for reliable clinical treatment in the future. Methods: A total of 180 children with inguinal hernia repair were randomly selected and divided into groups A, B and C, each with 60 children. A group (low dose group) was given remifentanil 0.03μg / kg -1, group B (middle dose group) was given remifentanil 0.06μg / kg -1, group C Dose group) was given 0.09μg / kg -1 remifentanil. Respiratory depression, including respiratory rate (RR) and tidal volume of ventilation (MV), were observed in three groups. After the laryngeal mask was placed in the patient (A), remifentanil After volume (B), continuous infusion 10min (C), continuous infusion after 15min (D), pull out the laryngeal mask (E). Results: There were no significant differences among the three groups at different time points (P> 0.05). At the time points of C, D and E, group A and group B were significantly higher than group C (P <0.05) , There was no significant difference between group B (P> 0.05). There was no significant difference in VT between different groups at any time (P> 0.05). There was no significant difference between the three groups at different time points (P> 0.05). MV in C, D, E group was significantly lower than that in A, B group (P <0.05) No difference between the two groups (P> 0.05). Conclusion: The lower concentration of remifentanil in pediatric sevoflurane anesthesia can reduce the inhibitory effect on respiration, try to keep the spontaneous respiration of children as high as possible.