Effect of Anesthesia Without Muscle Relaxant on Children Patients Undergoing Tonsillectomy and Adenoidectomy
Yu Bo;Wang Tao;Li Ling;Xia Yong;Wuhan Red Cross Hospital;Ezhou Hospital of Traditional Chinese Medicine;Ezhou Maternal and Child Health Hospital;
Objective To observe the clinical effect of general anesthesia induction with remifentanil,propofol and sevoflurane without muscle relaxant in children patients undergoing tonsillectomy and adenoidectomy. Methods Totally 84 children undergoing tonsillectomy and adenoidectomy in our hospital from July 2015 to August 2017 were selected and divided into the observation group( n = 48,without muscle relaxant) and the control group( n = 36,treated with vecuronium bromide). All patients were intravenously injected with propofol1 mg/kg,remifentanil 1. 0-1. 5 μg/kg,dexamethasone 1. 0-1. 5 μg/kg,the mask was given to pressurize oxygen after the patients' consciousness disappeared. The control group was given the muscle relaxant vecuronium 0. 1 mg/kg,and the tracheal intubation was assisted after 90 s. The observation group was intubated after inhaling pure oxygen 4 L/min + 8% sevoflurane for 2 min through mask. Continuous intravenous infusion of propofol and remifentanil,inhalation of 1% sevoflurane to maintain anesthesia. The values of the patients' heart rate( HR),mean arterial pressure( MAP),and pulse oxygen saturation( SpO_2) were recorded before induction of anesthesia( t0),immediately before intubation( t_1),at 3 min after intubations( t_2),at 5 min after intubations( t_3),and immediately after extubation( t_4).The eyelash reflex disappearance time,pain response disappearance time,recovery time and extubation time,and postoperative complications were recorded. Results The eyelash reflex disappearance time,pain response disappearance time,surgery time,postoperative recovery time,excubation time in the observation group were shorter than those in the control group( P 0. 05). The satisfaction rate of intubation in the observation group was 100. 00%,which was higher than 91. 67% in the control group( P 0. 05). The levels of MAP,SpO_2 and HR in the two groups at t_1,t_2,t_3 were lower than the baseline at t0( P 0. 05),and the levels of SpO_2 and HR in the control group were lower than those in the observation group( P 0. 05). The incidence rates of severe choking cough,agitation and vomit without nausea in the control group were significantly higher than those in the observation group( P 0. 05). Conclusion The general anesthesia induction with remifentanil,propofol and sevoflurane without muscle relaxant for children patients undergoing tonsillectomy and adenoidectomy is effective and safe,the anesthesia induction is smooth,and the intubation conditions are good.
【CateGory Index】： R726.1