盐酸阿芬太尼在小儿疝气腹腔镜手术全凭静脉麻醉诱导中的作用

Role of afentanil hydrochloride in induction of intravenous anesthesia in laparoscopic hernia surgery in children

摘要:

目的 分析盐酸阿芬太尼在小儿疝气腹腔镜手术全凭静脉麻醉诱导中的作用。方法 选取2024年9月—2025年2月安徽省儿童医院79例行腹腔镜疝气手术患儿为研究对象。按照全凭静脉麻醉诱导方法的不同分为两组，对照组（40例）应用舒芬太尼诱导，观察组（39例）应用盐酸阿芬太尼诱导。记录两组患儿麻醉诱导前（T₀）、喉罩置入时（T₁）、喉罩拔除时（T₂）的平均动脉压（MAP）和心率（HR）。并统计两组患儿的苏醒期疼痛情况（FLACC量表）、麻醉恢复指标及安全性。结果 观察组与对照组T₀、T₁、T₂时的MAP、HR比较，采用重复测量设计的方差分析，结果 ①不同时间点的MAP、HR比较，差异均有统计学意义（P <0.05）；②观察组与对照组的MAP、HR比较，差异均有统计学意义（P <0.05），观察组MAP、HR较低，血流动力学较为稳定；③两组MAP、HR的变化趋势比较，差异均有统计学意义（P <0.05）。观察组苏醒期FLACC评分高于对照组（P <0.05）。观察组自主呼吸恢复时间、睁眼时间、喉罩拔除时间及麻醉苏醒室停留时间均短于对照组（P <0.05）。观察组不良反应总发生率低于对照组（P <0.05）。结论 在小儿疝气腹腔镜手术时，盐酸阿芬太尼应用于全凭静脉麻醉诱导中，可获得较为平稳的血流动力学，并缩短麻醉恢复时间，减少不良反应的发生。

Abstract:

Objective To analyze the effect of afentanil hydrochloride on induction of intravenous anesthesia in laparoscopic surgery for children with hernia.Methods The clinical data of 79 children with laparoscopic hernia surgery admitted to Anhui Children's Hospital during September 2024 to February 2025 were retrospectively analyzed. They were divided into 2 groups according to different induction methods of intravenous anesthesia. 40 cases in the control group were induced by sufentanil, and 39 cases in the observation group were induced by afentanil hydrochloride.The mean arterial pressure (MAP) and heart rate (HR) of the two groups were recorded before anesthesia induction (T₀),during laryngeal mask placement (T₁) and laryngeal mask removal (T₂).The pain in the recovery period(FLACC scale),anesthesia recovery indexes and safety were analyzed in the two groups.Results The comparison of MAP and HR at T₀, T₁, and T₂ between the observation group and the control group was conducted using a repeated measures design analysis of variance.The results were as follows : (1) The comparison of MAP and HR at different time points showed statistically significant differences (P < 0.05). (2) There was a statistically significant difference in MAP and HR between the observation group and the control group (P < 0.05).The MAP and HR of the observation group were lower,and the hemodynamics were more stable. (3) The comparison of the changing trends of MAP and HR between the two groups showed statistically significant differences (P < 0.05). The FLACC score grades of pain during the recovery period in the observation group was higher than that in the control group (P < 0.05). The recovery time of spontaneous breathing,the time of eye opening,the time of laryngeal mask removal and the stay time in the anesthesia recovery room in the observation group were all lower than those in the control group (P < 0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05).Conclusion The application of afentanil hydrochloride in the induction of intravenous anesthesia in the laparoscopic operation of pediatric hernia can obtain relatively stable hemodynamics,shorten the recovery time of anesthesia and reduce the occurrence of adverse reactions.