中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (1): 45-48.doi: 10.19438/j.cjoms.2021.01.009

• 论著 • 上一篇    下一篇

瑞芬太尼复合氯胺酮在婴幼儿唇腭裂手术中的麻醉效果分析

林晓锐1, 李晨曦2,*, 张秀华1,*   

  1. 1.新疆医科大学第一附属医院 中心手术室,新疆 乌鲁木齐 830054;
    2.汉堡大学艾本德附属医院 头部及神经中心 口腔颌面外科, 口腔颌面部肿瘤遗传学及再生医学实验室,德国 汉堡 20246
  • 收稿日期:2020-03-09 修回日期:2020-08-24 出版日期:2021-01-20 发布日期:2021-02-19
  • 通讯作者: 李晨曦,E-mail:lichenximed@163.com;张秀华,E-mail:1966393739@qq.com。*共同通信作者
  • 作者简介:林晓锐（1985-）,女,护师,E-mail: 1345407971@qq.com

Analysis of anesthetic effect of remifentanil combined with ketamine in cleft lip and palate surgery in infants

LIN Xiao-rui1, LI Chen-xi2, ZHANG Xiu-hua1   

  1. 1. Central Operation Department, The First Affiliated Hospital of Xinjiang Medical University. Urumqi 830054, Xinjiang Uygur Autonomous Region, China;
    2. Department of Oral and Maxillofacial Surgery, Laboratory for Tumor Genetics and Regenerative Medicine, The Head and Neurocenter, University Hospital Hamburg-Eppendorf (UKE). Hamburg 20246, Germany
  • Received:2020-03-09 Revised:2020-08-24 Online:2021-01-20 Published:2021-02-19

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摘要： 目的: 评价瑞芬太尼复合氯胺酮在婴幼儿唇腭裂手术中的麻醉效果。方法: 选择2017年12月—2019年12月因先天性唇腭裂在汉堡大学艾本德附属医院行修补术的婴幼儿96例,按照入院顺序将患儿随机均分为试验组（48例）和对照组（48例）。对照组单用氯胺酮实施麻醉,试验组利用瑞芬太尼复合氯胺酮实施麻醉。从血压、心率及麻醉苏醒时间等方面,评估2组患儿的麻醉效果并记录氯胺酮的使用量。采用SPSS 22.0软件包对数据进行统计学分析。结果: 2组患儿术中、术后的呼吸、血氧饱和度与术前比较差异无统计学意义（P>0.05）;2组患儿手术前心率、平均动脉压无显著差异,术中、术后试验组患儿的心率、平均动脉压显著低于对照组（P<0.05）;试验组患儿的麻醉苏醒时间显著短于对照组,氯胺酮使用量显著低于对照组,呼吸抑制、气道分泌液增多、躁动发生率显著低于对照组（P<0.05）;2组患儿呕吐、喉痉挛、窒息、发热等不良反应发生率比较,差异无统计学意义（P>0.05）。结论: 瑞芬太尼复合氯胺酮作为婴幼儿唇腭裂修补术的麻醉剂,在维持血氧饱和度稳定的前提下,能改善血压、心率水平,缩短麻醉苏醒时间,减少呼吸抑制、气道分泌物,镇痛效果确切且安全性高。

关键词: 瑞芬太尼, 氯胺酮, 婴幼儿, 唇腭裂, 麻醉效果

Abstract: PURPOSE: To observe and analyze the anesthetic effect of remifentanil combined with ketamine in cleft lip and palate surgery of infants. METHODS: Ninety-six infants who underwent repair of congenital cleft lip and palate in our hospital from December 2017 to December 2019 were selected, the children were randomly divided into an experimental group (n=48) and a control group (n=48) according to the order of admission. Patients in the control group were anesthetized with ketamine alone, while patients in the experimental group were anesthetized by remifentanil combined with ketamine. The blood pressure, heart rate, and anesthesia recovery time were used to evaluate the anesthetic effect of the two groups of children and the amount of applied ketamine was recorded. SPSS 22.0 software package was performed for statistical analysis. RESULTS: There was no significant difference in the respiration and blood oxygen saturation between the two groups of children during and after surgery (P>0.05). There was no significant difference in heart rate and mean arterial pressure between the two groups of children before operation. The heart rate and mean arterial pressure of the children in the experimental group were significantly lower than those in the control group during and after surgery (P<0.05). The anesthesia wake-up time of the experimental group was significantly shorter than that of the control group, and the amount of applied ketamine was significantly lower than that of the control group. The incidence of respiratory depression, increased airway secretion, and agitation was significantly lower than that of the control group(P<0.05). There was no significant difference in the incidence of adverse reactions such as vomiting, laryngeal spasm, asphyxia and fever between the two groups of children (P>0.05). CONCLUSIONS: Remifentanil combined with ketamine as an anesthetic for cleft lip and palate repair in infants and young children could improve blood pressure, heart rate, shorten anesthesia recovery time, reduce respiratory depression and decrease airway secretions while maintaining stable blood oxygen saturation. Moreover, its analgesic effect is exact and the safety is high.

Key words: Remifentanil, Ketamine, Infants, Cleft lip and palate, Anesthetic effect

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