CAJ | 학술논문

目的：观察术中不同剂量舒芬太尼对小儿腹腔镜疝囊结扎术血流动力学和麻醉恢复的影响。方法：选择2～8岁择期行小儿腹腔镜疝囊高位结扎术的患儿63例，根据术中不同舒芬太尼使用剂量，随机分为3组，S1组0．6ug/kg，S2组0．8 ug/kg，S3组1．0 ug/kg。记录患儿气管插管后5分钟（ T0）、切皮（ T1）、气腹（ T2）及疝囊套扎（ T3）和停麻醉药后5分钟（ T4）的血流动力学变化，麻醉后恢复时间和副作用。结果：S2与S3组术中HR和MAP变化明显较S1组平稳（ P＜0．05）。 S1组术中需追加瑞芬太尼镇痛以及气管拔管后躁动，需追加舒芬太尼镇痛的患儿比例明显高于S2、S3组（ P＜0．05），而S3组出现拔管后非常镇静的患儿明显高于S1、S2组（P＜0．05）。3组患儿麻醉后恢复时间S1组＜S2组＜S3组（P＜0．05）。结论：小儿腹腔镜疝囊高位结扎术中舒芬太尼的适宜剂量为0．8ug/kg，该剂量术中血流动力学较平稳，镇痛不足发生率低，麻醉苏醒并发症少。
목적：관찰술중불동제량서분태니대소인복강경산낭결찰술혈류동역학화마취회복적영향。방법：선택2～8세택기행소인복강경산낭고위결찰술적환인63례，근거술중불동서분태니사용제량，수궤분위3조，S1조0．6ug/kg，S2조0．8 ug/kg，S3조1．0 ug/kg。기록환인기관삽관후5분종（ T0）、절피（ T1）、기복（ T2）급산낭투찰（ T3）화정마취약후5분종（ T4）적혈류동역학변화，마취후회복시간화부작용。결과：S2여S3조술중HR화MAP변화명현교S1조평은（ P＜0．05）。 S1조술중수추가서분태니진통이급기관발관후조동，수추가서분태니진통적환인비례명현고우S2、S3조（ P＜0．05），이S3조출현발관후비상진정적환인명현고우S1、S2조（P＜0．05）。3조환인마취후회복시간S1조＜S2조＜S3조（P＜0．05）。결론：소인복강경산낭고위결찰술중서분태니적괄의제량위0．8ug/kg，해제량술중혈류동역학교평은，진통불족발생솔저，마취소성병발증소。
To investigate the effects of Sufentanil with different doses on intraoperrative hemodynamic changes and postoperative anesthesia recovery in children undergoing laparoscopic hernia surgery .Methods:Sixty-three ASA I chil-dren , aged 2 ~8 yr , undergoing elective laparoscopic hernia surgery were randomly divided into three groups :Group S1 ( 0 .6 ug/kg) , Group S2 ( 0 .8 ug/kg) and Group S3 ( 1 ug/kg) , according to the intraoperative total dose of sufentanil . The hemodynamic changes , including heart rates ( HR) and mean arterial pressure ( MAP) , at time points of 5 min after in-tubation (T0),Skin incision (T1), pneumoperitoneum (T2) , ligation of hernia (T3) and 5 min after cessation of anes-thetics ( T4 ) were recorded .Besides, the recovery time and side effects after anesthesia were recorded as well ..Results:The HR and MAP demonstrated to be more stable both in group S 3 and group S2 than group S1 ( P<0 .05 ) .The children need additional remifentanil during surgery , appear to agitation after extubation and need rescue postoperative sufentanil an -algesia were significantly more in group S 1 than in groups S2 and S3 ( P<0 .05 ) .The children falling into deep sedation af-ter extubation were significantly more in group S 3 than in groups S1 and S2 ( P<0 .05 ) .The recovery time after anesthesia was significantly shorter in group S 1 than group S2 , and in group S2 than group S3 ( S1 <S2 <S3 ) ( P<0 .05 ) .Conclu-sion:The optimal intraoperative dose of sufentanil for children undergoing laparoscopic hernia surgery is 0 .8 ug/kg, which might provide a comparative stable hemodynamics during surgery and better postoperative analgesia but should have fewer complications during anesthesia recovery .