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2022, v.32(03) 226-229+235

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咪哒唑仑及丙泊酚联合低浓度舒芬太尼在小儿腹腔镜下疝内环口缝扎术中的应用效果分析
Analysis of the Application Effect of Midazolam and Propofol Combined with Low Concentration Sufentanil in Laparoscopic Laparoscopic Hernia Suture Ligation

王娜;韩文东;陈媛媛;冯宁;
WANG Na;HAN Wendong;CHEN Yuanyuan;FENG Ning;Department of Anesthesiology,Anyang Sixth People′s Hospital;

摘要(Abstract):

目的 探讨咪哒唑仑及丙泊酚联合低浓度舒芬太尼在小儿腹腔镜下疝内环口缝扎术中的应用效果。方法 选取2018年2月~2020年12月某院收治的82例小儿腹股沟斜疝患者,根据麻醉方式的差异将患者分为研究组(咪哒唑仑及丙泊酚联合低浓度舒芬太尼,n=42)和对照组(哒唑仑及丙泊酚联合高浓度舒芬太尼,n=40)。对比两组手术相关指标、术中不同时间段[插管前(t_0)、插管后(t_1)、手术开始时(t_2)、手术结束时(t_3)]的心率(heart rate, HR)和平均动脉压(mean arterial pressure, MAP)、术后不同时间段(术后4 h、术后8 h、术后12 h以及术后24 h)的疼痛情况(wong-baker脸谱法)及镇静情况(Ramsay镇静评分)以及不良反应。结果 (1)两组麻醉诱导时间、拔管时间、苏醒时间以及定向力恢复时间对比差异无统计学意义(P>0.05);(2)两组插管后HR、MAP呈先降后升趋势(P<0.05),t_1~t_3时间段,研究组HR、MAP水平均高于对照组(P<0.05);(3)两组术后疼痛评分均呈逐渐下降趋势,两组术后不同时间段的疼痛评分对比差异无统计学意义(P>0.05);(4)两组术后镇静评分均呈逐渐上升趋势,两组术后不同时间段的镇静评分对比差异无统计学意义(P>0.05);(5)两组不良反应发生率差异无统计学意义(P>0.05)。结论 咪哒唑仑及丙泊酚联合低浓度舒芬太尼在小儿腹腔镜下疝内环口缝扎术中应用效果较佳,可有效保证麻醉深度,且具有一定的安全性,值得临床推广应用。
OBJECTIVE To investigate the application effect of midazolam and propofol combined with low concentration sufentanil in laparoscopic suture ligation of the internal ring orifice of hernia in children. METHODS A total of 82 pediatric patients with indirect inguinal hernia admitted to our hospital from February 2018 to December 2020 were selected.According to the differences in anesthesia methods, the patients were divided into study group(midazolam and propofol combined with low-concentration sufentanil, n=42) and the control group(dazolam and propofol combined with high concentration sufentanil, n=40).The two groups of surgery-related indicators, heart rate(HR) and Mean arterial pressure(MAP) at different time periods during the operation[before intubation(t_0),after intubation(t_1),the beginning of the operation(t_2),the end of the operation(t_3)],postoperative pain in different time periods(postoperative 4 h, postoperative 8 h, postoperative 12 h, and postoperative 24 h)[wong-baker facebook method] and sedation [Ramsay sedation score],adverse reactions were compared. RESULTS(1) There was no significant difference between the two groups of anesthesia induction time, extubation time, awakening time and orientation recovery time(P>0.05).(2) HR and MAP showed a trend of first decreasing and then increasing after intubation(P<0.05).From t_1 to t_3,the HR and MAP levels of the study group were higher than those of the control group(P<0.05).(3) The postoperative pain scores of the two groups showed a gradual downward trend, and there was no significant difference in the pain scores of the two groups at different time periods after surgery(P>0.05).(4) The postoperative sedation scores of the two groups showed a gradual upward trend, and there was no significant difference in the sedation scores of the two groups at different time periods after surgery(P>0.05).(5)There was no significant difference in the incidence of adverse reactions between the two groups(P<0.05). CONCLUSION Midazolam and propofol combined with low-concentration sufentanil have better application effects in laparoscopic laparoscopic hernia suture ligation, which can effectively ensure the depth of anesthesia, and has a certain degree of safety.It is worthy of clinical promotion application.

关键词(KeyWords): 咪哒唑仑;丙泊酚;小儿腹腔镜下疝内环口缝扎术;低浓度舒芬太尼;不良反应
midazolam;propofol;laparoscopic internal loop suture ligation of hernia in children;low concentration sufentanil;adverse reactions

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作者(Authors): 王娜;韩文东;陈媛媛;冯宁;
WANG Na;HAN Wendong;CHEN Yuanyuan;FENG Ning;Department of Anesthesiology,Anyang Sixth People′s Hospital;

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