[Effects of remifentanil in children undergoing endoscopic-assisted adenoidectomy].

Songmei Li, Haixia Xu, Sulian Guo
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Abstract

Objective: To observe the effect of remifentanil on hemodynamic and angiotentratin- II in children undergoing endoscopic-assisted adenoidectomy.

Method: Thirty patients, ASA I -II , were randomly divided into two groups , remifentanil group and fentanyl group. Remifentanil group received remifentanil combined with propofol anesthesia, fentanyl group received fentanyl combined with propofol anesthesia . Vecuronium was given as muscle relaxant in both groups. ECG, HR, BP, Sa02 were monitored in both groups during operation,and peripheral venous blood samples were taken on 1d before operation(T1),at the time of endotracheal intubation (T2 ), 10 minutes after operation beginning (T3 ),5 minutes after extubation (T4 ) for check angiotentratin- II , then recorded the time of anesthesia, the time of recovery from anesthesia and the time of extubation.

Result: Comparing with T1, T2, and T3 were significant lower in both group about the HR, BP and angiotentratin-II. There was no significant difference in two groups about SaO2. HR and BP is little lower in remifentanil group than in fentanyl group . The anesthesia time was significantly longer in Remifentanil group than that in fentanyl group. The recovery time was significantly shorter in Remifentanil group than that in fentanyl group. The extubation time was significantly shorter in remifentanil group than that in fentanyl group.

Conclusion: Remifentanil is better than fentanyl for stabilizing hemodynamic,decreasing the stress responses,reducing the time of recovery and extubation in children undergoing endoscopic-assisted adenoidectomy.

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[瑞芬太尼在儿童内镜辅助腺样体切除术中的作用]。
目的:观察瑞芬太尼对内镜下腺样体切除术患儿血流动力学及血管紧张素- II的影响。方法:30例ASA I -II级患者随机分为瑞芬太尼组和芬太尼组。瑞芬太尼组采用瑞芬太尼联合异丙酚麻醉,芬太尼组采用芬太尼联合异丙酚麻醉。两组均给予维库溴铵作为肌肉松弛剂。术中监测两组患者心电图、HR、BP、Sa02,并于术前1d (T1)、气管插管时(T2)、手术开始后10分钟(T3)、拔管后5分钟(T4)取外周静脉血检查血管张力- II,记录麻醉时间、麻醉恢复时间、拔管时间。结果:与T1比较,两组患者T2、T3时HR、BP及血管紧张素水平均显著降低。两组患者SaO2水平差异无统计学意义。瑞芬太尼组HR和BP较芬太尼组稍低。瑞芬太尼组麻醉时间明显长于芬太尼组。瑞芬太尼组恢复时间明显短于芬太尼组。瑞芬太尼组拔管时间明显短于芬太尼组。结论:在内镜下腺样体切除术患儿中,瑞芬太尼比芬太尼更能稳定血流动力学,减少应激反应,缩短恢复时间和拔管时间。
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