Objective To evaluate the clinical efficacy of fentanil,remifentanil combined propfol anesthesia in pediatric ophthalmology operation. Methods Sixty pediatric ophthalmology surgeryies were randomly divided into treatment group(A group,n = 30) and contrast group (B group, n = 30). Anesthesia was induced with fentanil in the treatment group, while remifentanil in contrast one, and maintained with remifentanil and propfol in both groups. The SBP, DBP, HR were measured before induction(T1 ), after induction(T2), intubation(T3 ), beginning of operation (T4) ,end of operation (T5)and extubation(T6 ), the times recovery of respiration and extubation were recorded,and vomiting and restlessness were observed as well during the reviving. Results Compared with T1, the SBP, DBP and HR of B group was significantly lower A group at T2 (P＜0. 01) ;No difference was observed which increased in the two groups at T3 ;which was significantly lower again at T4 ,T5 (P＜0.01) ;which B group was increased than A group at T6 (P＜0.05) ;vomiting and restlessness A group lower than B group. Conclusion Fentanil,remifentanil combined propfol anesthesia provides better stablilization in pediatric ophthalmology operation induction and extubation,low rate restlessness.%目的 观察芬太尼、雷米芬太尼复合丙泊酚静脉麻醉用于小儿眼科手术的临床效果.方法 将60例患儿随机分为观察组30例和对照组30例.诱导时观察组采用芬太尼而对照组采用雷米芬太尼,两组都持续静脉输入雷米芬太尼和丙泊酚行维持麻醉.分别记录两组诱导前(T1)、诱导后(T2)、插管时(T3)、手术开始时(T4)、手术结束时(T5)、拔管时(T6)的收缩压(SBP)、舒张压(DBP)、心率(HR),同时记录术后咽喉反射恢复时间、拔管时间、对语言指令反应恢复时间,并记录苏醒期是否有躁动、呕吐发生等.结果 与T1相比,两组患儿T2时收缩压、舒张压下降,HR减慢,对照组变化明显(P＜0.01);T3时SBP、DBP升高,HR增快,但差异无统计学意义;T4 、T5时SBP、DBP明显下降,HR明显减慢(P＜0.01);T6时 SBP、DBP升高,HR增快,且两组比较差异有统计学意义(P＜0.05);观察组术后躁动发生率显著低于对照组(P＜0.01).结论 芬太尼、雷米芬太尼复合丙泊酚静脉麻醉用于小儿眼科手术效果好,诱导和拔管时BP、HR波动相对较小,术后躁动发生率低.
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