Application value and safety of sub-dose remifentanil combined with propofol in the maintenance of intravenous anesthesia in children
Objective To observe the efficacy and safety of sub-dose remifentanil combined with propofol in pediatric intravenous anesthesia maintenance.Methods This was a randomized controlled trial.A total of 125 children who underwent surgery in the First Affiliated Hospital of Nanyang Medical College from January 2021 to January 2023 were prospectively selected as the study objects and were divided into 3 groups by drawing lots.In the conventional dose group,the ratio of boys to girls was 22/20,the age was(9.45±1.23)years old,and the types of surgery were as follows:22 cases of hernia surgery,10 cases of tonsillectomy,and 10 cases of orthopedic surgery.In the sub-dose group,the ratio of boys to girls was 20/21,the age was(9.33±1.16)years old,and the types of surgery were as follows:22 cases of hernia surgery,10 cases of tonsillectomy,and 9 cases of orthopedic surgery.In the low-dose group,the ratio of boys to girls was 23/19,and the age was(9.52±1.31)years old,and the types of surgery were as follows:21 cases of hernia surgery,11 cases of tonsillectomy,and 10 cases of orthopedic surgery.The conventional dose group was given 1.00 μg/kg remifentanil combined with propofol to maintain anesthesia,the low-dose group was given 0.25 μg/kg remifentanil combined with propofol to maintain anesthesia,and the sub-dose group was given 0.50 μg/kg remifentanil combined with propofol to maintain anesthesia.The changes in basic physical signs during the perioperative period,postoperative recovery,pain relief,and anesthesia-related adverse reactions of the 3 groups were compared.x2 test,F test,and independent sample t test were used.Results Before surgery,there were no statistically significant differences in the heart rate(HR)and mean arterial pressure(MAP)among the 3 groups(both P＞0.05).Ten min after anesthesia,the HR and MAP of the sub-dose group were(73.45±5.22)beats/min and(79.11±5.33)mmHg(1 mmHg=0.133 kPa),which were higher than those of the conventional dose group[(70.14±5.17)beats/min and(76.62±5.41)mmHg](both P＜0.05),but there were no statistically significant differences compared with those of the low dose group[(74.49±5.23)beats/min and(80.25±5.41)mmHg](both P＞0.05).At the time of tracheal intubation,the HR and MAP of the sub-dose group were(80.33±5.26)beats/min and(81.25±5.45)mmHg,which were lower than those of the low-dose group[(83.28±5.41)beats/min and(84.49±5.18)mmHg](both P＜0.05),but there were no statistically significant differences compared with those of the convenitional dose group[(79.45±5.31)beats/min and(80.44±5.32)mmHg](both P＞0.05).Thirty min after intubation,the HR and MAP of the sub-dose group were(79.45±10.13)beats/min and(80.23±10.16)mmHg,which were higher than those of the conventional dose group[(72.15±10.49)beats/min and(73.22± 10.25)mmHg]but were lower than those of the low dose group[(86.39±10.22)beats/min and(87.24±10.18)mmHg](all P＜0.05).At the end of surgery,the HR and MAP of the sub-dose group were(80.24±10.32)beats/min and(83.39±10.47)mmHg,which were higher than those of the conventional dose group[(74.11±10.46)beats/min and(77.25±10.35)mmHg],but were lower than those of the low dose group[(87.15±10.36)beats/min and(90.72±10.18)mmHg](all P＜0.05).After surgery,the recovery time of the sub-dose group[(11.45±5.46)min]was shorter than that of the conventional dose group[(14.28±5.33)min](P＜0.05),and there was no statistically significant differencecompared with that of the low dose group[(10.49±5.2 6)min](P＞0.0 5).The VAS score of the sub-dose group[(3.29±1.27)points]was lower than that of the low-dose group[(4.17±1.34)points](P＜0.05),but there was no statistically significant difference compared with that of the conventional dose group[(3.18±1.45)points](P＞0.05).The incidence of anesthesia-related adverse reactions in the sub-dose group was 9.76％(4/41),which was lower than that in the conventional dose group[28.57％(12/42)],with a statistically significant difference(P＜0.05);it was slightly higher than that in the low-dose group[7.14％(3/42)],with no statistically significant difference(P＞0.05).Conclusion The use of 0.50 μg/kg remifentanil combined with propofol in pediatric intravenous anesthesia maintenance can effectively maintain the stability of basic signs in children during surgery,and produce significant analgesic effect,which has positive significance in promoting the children's recovery and reducing the risk of postoperative anesthesia-related adverse reactions.
万方数据
维普
