在小儿患者经胸封堵室间隔缺损中，右美托咪定和瑞芬太尼与舒芬太尼为基础的全身麻醉效果比较。
A comparison of the outcomes of dexmedetomidine and remifentanil with sufentanil-based general anesthesia in pediatric patients for the transthoracic device closure of ventricular septal defects.
作者信息
Yu Ling-Shan, Xie Wen-Peng, Liu Jian-Feng, Wang Jing, Cao Hua, Wang Zeng-Chun, Chen Qiang
机构信息
Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China.
出版信息
J Cardiothorac Surg. 2021 Apr 23;16(1):111. doi: 10.1186/s13019-021-01498-8.
OBJECTIVE
To compare the safety and efficacy of dexmedetomidine and remifentanil with sufentanil-based general anesthesia for the transthoracic device closure of ventricular septal defects (VSDs) in pediatric patients.
METHODS
A retrospective analysis was performed on 60 children undergoing the transthoracic device closure of VSDs from January 2019 to June 2020. The patients were divided into two groups based on different anesthesia strategies, including 30 cases in group R (dexmedetomidine- and remifentanil-based general anesthesia) and 30 cases in group S (sufentanil-based general anesthesia).
RESULTS
There was no significant difference in preoperative clinical information, hemodynamics before induction and after extubation, postoperative pain scores, or length of hospital stay between the two groups. However, the hemodynamic data of group R were significantly lower than those of group S at the time points of anesthesia induction, skin incision, thoracotomy, incision closure, and extubation. The amount of intravenous patient-controlled analgesia (PCA), the duration of mechanical ventilation, and the length of the intensive care unit (ICU) stay in group R were significantly less than those in group S.
CONCLUSION
Dexmedetomidine combined with remifentanil-based general anesthesia for the transthoracic device closure of VSDs in pediatric patients is safe and effective.
目的
比较右美托咪定联合瑞芬太尼与舒芬太尼用于小儿经胸封堵室间隔缺损（VSD）全身麻醉的安全性和有效性。
方法
对2019年1月至2020年6月期间60例行小儿经胸封堵VSD的患儿进行回顾性分析。根据不同麻醉策略将患者分为两组，R组（右美托咪定联合瑞芬太尼全身麻醉）30例，S组（舒芬太尼全身麻醉）30例。
结果
两组术前临床资料、诱导前及拔管后血流动力学、术后疼痛评分及住院时间比较，差异均无统计学意义。然而，R组在麻醉诱导、皮肤切开、开胸、切口关闭及拔管时的血流动力学数据显著低于S组。R组静脉自控镇痛（PCA）用量、机械通气时间及重症监护病房（ICU）住院时间均显著少于S组。
结论
右美托咪定联合瑞芬太尼用于小儿经胸封堵VSD全身麻醉安全有效。
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