The application effect of ketamine and remifentanil in pediatric ophthalmic laryngeal mask placement general anesthesia surgery
10.3760/cma.j.cn115455-20240227-00183
- VernacularTitle:氯胺酮与瑞芬太尼在小儿眼科喉罩置入全身麻醉手术中的应用效果
- Author:
Xiaomin ZHANG
1
;
Xiaoyan LI
;
Xiaoru GAO
Author Information
1. 张家口市第四医院手麻科，张家口 075000
- Keywords:
Ketamine;
Remifentanil;
Pediatric ophthalmic surgery;
General anesthesia;
Propofol
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(9):823-828
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application effect of ketamine and remifentanil in pediatric ophthalmic laryngeal mask placement general anesthesia surgery.Methods:A total of 68 children who underwent ophthalmic laryngeal mask placement general anesthesia surgery in Zhangjiakou Fourth Hospital from July 2020 to May 2023 were prospectively selected and they were randomly separated into a ketamine group (34 cases, anesthesia with ketamine combined with propofol) and a remifentanil group (34 cases, propofol combined with remifentanil). The mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO 2) of the two groups were compared at before anesthesia (T 1), after anesthesia (T 2), intraoperative 5 min (T 3), intraoperative 20 min (T 4) and after surgery (T 5). Meantime, the satisfaction with anesthesia among the surgeons, perioperative adverse reactions, surgical duration, recovery time and time to transfer out of the postanesthesia care unit (PACU) were compared between the two groups. Results:The MAP and HR of the remifentanil group at T 2 to T 4 were lower than before anesthesia, MAP: (72.83 ± 8.25), (74.18 ± 8.57) and (74.49 ± 9.13) mmHg (1 mmHg = 0.133 kPa) vs. (76.26 ± 9.51) mmHg; HR: (83.21 ± 6.63), (85.18 ± 7.06) and (86.81 ± 7.53) times/min vs. (89.72 ± 7.46) times/min ( P< 0.05), while the MAP and HR of the ketamine group at T 2 to T 5 were higher than before anesthesia, MAP: (81.67 ± 9.31), (85.06 ± 11.25), (86.34 ± 11.56) and (87.51 ± 9.30) mmHg vs. (77.58 ± 10.22) mmHg; HR: (95.04 ± 9.78), (97.60 ± 8.24), (98.64 ± 10.47) and (100.21 ± 8.56) times/min vs. (88.53 ± 9.15) times/min ( P<0.05), there was no difference in SpO 2 in the two groups between T 2 to T 5 and T 1 ( P>0.05), while the MAP and HR of the remifentanil group were lower than those of the ketamine group at T 2 to T 5, MAP: (72.83 ± 8.25) mmHg vs. (81.67 ± 9.31) mmHg, (74.18 ± 8.57) mmHg vs. (85.06 ± 11.25) mmHg, (74.49 ± 9.13) mmHg vs. (86.34 ± 11.56) mmHg, (75.38 ± 8.96) mmHg vs. (87.51 ± 9.30) mmHg; HR: (83.21 ± 6.63) times/min vs. (95.04 ± 9.78) times/min, (85.18 ± 7.06) times/min vs. (97.60 ± 8.24) times/min, (86.81 ± 7.53) times/min vs. (98.64 ± 10.47) times/min, (88.45 ± 9.51) times/min vs. (100.21 ± 8.56) times/min ( P<0.05), there was no difference in T 2 to T 5 SpO 2 between the two groups ( P>0.05); the satisfaction with anesthesia among the surgeons in the remifentanil group was higher than that in the ketamine group: 82.35% (28/34) vs. 58.82% (20/34), and the incidence of perioperative adverse reactions was lower than that in the ketamine group: 11.76% (4/34) vs. 32.35% (11/34); the surgical time, recovery time, and time to transfer out of PACU in the remifentanil group were all shorter than those in the ketamine group: (48.26 ± 9.54) min vs. (56.32 ± 11.86) min, (13.84 ± 4.12) min vs. (18.36 ± 5.08) min, (21.50 ± 6.14) min vs. (27.98 ± 8.62) min ( P<0.05). Conclusions:Compared with ketamine, remifentanil has a better effect in pediatric ophthalmic laryngeal mask placement general anesthesia surgery, which is more conducive to stabilizing the cardiovascular system during surgery, reducing the occurrence of adverse reactions such as perioperative restlessness, and shortening the surgical time and recovery time.
