Na Yun Chan, Lee Hyung Gon, Lee Seong Heon, Jang Eun A, Yoon Myung Ha
Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
Korean J Anesthesiol. 2014 Dec;67(6):373-7. doi: 10.4097/kjae.2014.67.6.373. Epub 2014 Dec 29.
The aims of this study were to compare the efficacy of sevoflurane inhalation alone, intravenous remifentanil alone, and the combination of sevoflurane inhalation and remifentanil as pretreatment for the prevention of rocuronium-induced withdrawal movement in pediatric patients.
In this prospective, randomized study, 90 American Society of Anesthesiologists physical status I or II pediatric patients aged 3 to 10 years were randomly allocated to one of three treatment groups: The Group S comprising the patients receiving sevoflurane inhalation, the Group R comprising those doing intravenous remifentanil 0.5 µg/kg and the Group C comprising those doing sevoflurane inhalation+intravenous remifentanil 0.5 µg/kg. The response of the patients was graded based on a 4-point scale.
The overall incidence of withdrawal movement on rocuronium injection was 54% (16/30) in the Group S, 57% (17/30) in the Group R and 17% (5/30) in the Group C. There was no significant difference in the incidence of withdrawal movements on rocuronium injection between the Group S and Group R. In addition, the incidence of withdrawal movements and generalized movement on rocuronium injection was significantly lower in the Group C as compared with the Group S and R (P < 0.05).
Our results indicate not only that there was no significant difference in the degree of the effect in lowering the incidence of withdrawal movements on rocuronium injection between sevoflurane inhalation and intravenous remifentanil but also that it was significantly higher when combined with intravenous remifentanil as compared with the single use of sevoflurane inhalation or intravenous remifentanil.
本研究旨在比较单纯吸入七氟醚、单纯静脉注射瑞芬太尼以及吸入七氟醚与静脉注射瑞芬太尼联合应用作为预处理措施预防小儿患者罗库溴铵诱发退缩运动的效果。
在这项前瞻性随机研究中，90例年龄3至10岁、美国麻醉医师协会身体状况分级为I或II级的小儿患者被随机分配至三个治疗组之一：S组为接受七氟醚吸入的患者，R组为静脉注射0.5μg/kg瑞芬太尼的患者，C组为吸入七氟醚+静脉注射0.5μg/kg瑞芬太尼的患者。根据4分制对患者的反应进行分级。
注射罗库溴铵时退缩运动的总体发生率在S组为54%（16/30），R组为57%（17/30），C组为17%（5/30）。S组和R组在注射罗库溴铵时退缩运动的发生率无显著差异。此外，C组注射罗库溴铵时退缩运动和全身运动的发生率显著低于S组和R组（P<0.05）。
我们的结果表明，不仅吸入七氟醚和静脉注射瑞芬太尼在降低注射罗库溴铵时退缩运动发生率的效果程度上无显著差异，而且与单纯吸入七氟醚或静脉注射瑞芬太尼相比，联合静脉注射瑞芬太尼时该发生率显著更高。
