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| 阿芬太尼和舒芬太尼用于患儿腹腔镜疝囊高位结扎术的效果比较 |
| Comparison of effect of alfentanil versus sufentanil in high ligation of laparoscopic hernia sac in children |
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| DOI：10.12089/jca.2021.12.007 |
| 中文关键词: 阿芬太尼 儿童 腹股沟斜疝 镇痛 |
| 英文关键词: Alfentanil Child Inguinal hernia Analgesia |
| 基金项目: |
| 作者 | 单位 | E-mail | | 龙翔 | 443003,湖北省宜昌市,三峡大学麻醉与急危重症医学研究所,三峡大学第一临床医学院,宜昌市中心人民医院麻醉科 | | | 查宁晖 | 443003,湖北省宜昌市,三峡大学麻醉与急危重症医学研究所,三峡大学第一临床医学院,宜昌市中心人民医院麻醉科 | | | 曾萍 | 443003,湖北省宜昌市,三峡大学麻醉与急危重症医学研究所,三峡大学第一临床医学院,宜昌市中心人民医院麻醉科 | | | 龚园 | 443003,湖北省宜昌市,三峡大学麻醉与急危重症医学研究所,三峡大学第一临床医学院,宜昌市中心人民医院麻醉科 | gy-yc@163.com |
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| 中文摘要: |
目的 比较阿芬太尼和舒芬太尼用于患儿腹腔镜疝囊高位结扎术的安全性和有效性。
方法 选择2020年12月至2021年1月全麻下择期行腹腔镜下疝囊高位结扎术患儿38例，男31例，女7例，月龄12～72个月，ASA Ⅰ级。随机分为两组：舒芬太尼组（SF组，n=19）和阿芬太尼组（AF组，n=19）。AF组采用阿芬太尼10 μg/kg诱导，术中持续泵注阿芬太尼0.8 μg·kg-1·min-1维持麻醉；SF组采用舒芬太尼0.3 μg/kg诱导，术中持续泵注0.9%生理盐水。两组肌松药物和七氟醚用量相同。记录麻醉诱导前、麻醉诱导后1 min、气管插管即刻、切皮时、气腹建立时的HR和MAP；记录拔管时间、苏醒时间；记录在PACU苏醒期FLACC疼痛评分等级；记录入PACU时、入PACU后30 min、出PACU即刻Ramsay镇静评分。
结果 与SF组比较，AF组苏醒时间明显缩短（P＜0.05）。两组不同时点HR、MAP、拔管时间、PACU苏醒期FLACC疼痛评分等级和不同时点Ramsay镇静评分差异无统计学意义。
结论 阿芬太尼和舒芬太尼均可安全有效应用于患儿腹腔镜下疝囊高位结扎术麻醉诱导与维持，血流动力学波动小。阿芬太尼10 μg/kg诱导时患儿苏醒时间短。 |
| 英文摘要: |
Objective To compare the safety and efficacy of alfentanil and sufentanil in laparoscopic high ligation of hernia sac in children.
Methods Thirty-eight children undergoing laparoscopic hernia sac high ligation under general anesthesia were selected from December 2020 to January 2021, 31 males and 7 females, aged 12-72 months, ASA physical status Ⅰ, were randomly divided into two groups: sufentanil group (group SF, n = 19) and alfentanil group (group AF, n = 19). The group AF were induced with alfentanil at 10 μg/kg and maintained anesthesia with alfentanil at 0.8 μg·kg-1·min-1. Group SF was induced at sufentanil 0.3 μg/kg, 0.9% normal saline was pumped continuously during the operation, and the dosage of muscle relaxant and sevoflurane remained unchanged. HR and MAP were recorded before anesthesia induction, 1 minute after anesthesia induction, immediately after endotracheal intubation, incision, pneumoperitoneum establishment, respectively. The extubation time and recovery time were recorded. The highest behavioral Face, Legs, Activity, Crying, Consolability (FLACC) score during PACU recovery was recorded, and Ramsay sedation score at PACU induction, 30 minutes, and discharge from PACU was recorded.
Results Compared with group SF, group AF had significantly shorter recovery time (P < 0.05). There were no statistical significance in HR, MAP, extubation time, the distribution of FLACC pain score during awakening period and Ramsay sedation score between the two groups.
Conclusion Alfentanil and sufentanil can be used safely and effectively for inducing and maintaining anesthesia during laparoscopic high ligation of hernia sac in children, HR and MAP fluctuations are mild, and waking time is short when using 10 μg/kg alfentanil induction. |
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