| Objective: To investigate the effect of sufentanil-propofol onarousal time, hemodynamics, recoveryquality and postoperative analgesia in children patients with scoliosis surgery.Methods: 50 cases of children with scoliosis spinal surgery were randomly divided into sufentanil group(S group) and remifentanil group(R group), all 25 cases, anesthesia was induced with midazolam 0.1mg / kg, rocuronium 0.6mg / kg, propofol 3mg / kg. S Group sufentanil 0.5μg / kg, R group remifentanil 3μg / kg. Intubation and mechanical ventilation, two groups are continuous intravenous infusion of propofol 5mg /(kg·h), rocuronium0.2mg /(kg·h) to maintain anesthesia. At the same time, S group, continuous intravenous infusion of sufentanil 0.01-0.03μg /(kg·min), R group continuous intravenous infusion of remifentanil 0.1-0.3μg /(kg·min). Stop rocuronium, sufentanil and remifentanilpumped at 30 min before arousal, and need to pumppropofol when we start arousal. If you need to arousal after successful surgery for a long time to maintain the awake state continues with propofol, sufentanil or remifentanil pumped to maintain anesthesia. After the arousal test with propofol 0.5mg / kg, rocuronium 0.2mg/kg intravenously, continue with propofol, sufentanil or or remifentanil pumped to maintain anesthesia.After stopping administration, patient groups to observe the situation, arousal time: the emergence of spontaneous breathing time(time records since the beginning of the withdrawal), body movement time appear able to cope with instruction time; patients with or without agitation; Hemodynamics: Stop After drug 10min(T1), when the arousal(T2), wake after 10min(T3) in patients with mean arterial pressure(MAP) mm Hg, heart rate(HR) beats / min; awakening quality; postoperative pain: postoperative visual analog scale(VAS) score.Results: S group during the wake up time for the beginning of spontaneous breathing(24.08 ± 2.46) min, body movement time(25.99 ± 2.89) min, can be used with the instruction time was(28.03 ± 3.16) min appear; R group during the wake up and start breathing on his own The time was(18.42 ± 1.51) min, the emergence of body motion time(19.26 ± 1.76) min, can be used with the instruction time was(21.37 ± 1.92) min. S group of patients began breathing on his own time, the time appears and the body movement instruction time compared with R group delay, the two groups began breathing on his own time, and with time the body movement instruction time were statistically significant differences appear(P <0.05).During the wake S group, restlessness 16%(4/25) was significantly lower than the R group agitation rate of 44%(11/25), the difference was statistically significant(P <0.05).S group when awakened, awakening quality grade I patients accounted for 64%(16/25), II stage patients accounted for 20%(5/25), III stage patients accounted for 12%(3/25), IV stage patients accounted for 4%( 1/25); group when R wake, awake quality grade I patients accounted for 44%(11/25), II stage patients accounted for 12%(3/25), III stage patients accounted for 24%(6/25), IV level 20% of patients(5/25). Awakening quality at all levels between the two groups was significantly(P <0.05), awakening quality was significantly better than the R S group.Two T1, T2, T3 moment MAP, HR was no significant difference(P> 0.05). S Group T1, T2 time MAP, HR difference was(10.86 ± 5.42) mm Hg,(22.15 ± 6.46)(times / min); R group T1, T2 time MAP, HR difference was(16.98 ± 7.83) mm Hg,(26.59 ± 7.22)(times / min). S Group T1, T2 time MAP, HR was significantly less than the difference between the R group, two groups T1, T2 time MAP, HR difference was statistically significant(P<0.05).S group, postoperative 1hVAS score was(16.72 ± 11.49), after 2hVAS score was(18.57 ± 10.88); R group, postoperative 1hVAS score was(34.46 ± 11.39), after 2hVAS score was(31.38 ± 10.91). S group after 1,2h VAS scores were significantly lower than R group, the difference was statistically significant(P<0.05).Conclusions: Sufentanil-propofol applied wake scoliosis surgery in this study, can make blood flow in patients with more stable dynamics during the patient wakes up, awakening high quality and good postoperative analgesia. In the wake of sufentanil and propofol can better be applied to scoliosis surgery anesthesia, but the arousal time is relatively extended. |
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