Application of remifentanil and propofol in pediatric palatoplasty

Objective: To compare the hemodynamic change and analepsia quality after application of remifentanil or fentanyl in children palatoplasty.Methods: A total of 40 children with palatoplasty were selected,and randomly divided into remifentanil group(Group R) and fentanyl group(Group F) with 20 cases each group.Venous injection of propofol at 2 mg/kg and atracurium at 0.75 mg/kg were given to both groups,besides remifentanil at 2.5 μg/kg was used in Group R and fentanil at 3 μg/kg was used in Group F.Mechanical ventilation was employed after tracheal intubation.During surgery,venous injection of propofol at 50-100 μg/(kg·min),atracurium at 5-10 μg/(kg·min) was carried out.Remifentanil at 0.08-0.5 μg/(kg·min) was used in Group R,and fentanil at 0.07-0.25 μg/(kg·min) was used in Group F.Mean artery pressure(MAP),heart rate(HR) and pulse oxygen saturation(SpO2)were recorded before anesthesia induce(T1),as intubation(T2),at the begin of surgery(T3),at 30 min during surgery(T4),at the end of surgery(T5) and as extubation(T6).Recovery time of spontaneous breathing,eye-opening time,extubation time,status of restlessness,nausea and vomiting were observed closely.Results: Group R had significantly lower MAP as intubation and extubation(P0.05).And the HR was significantly lower in Group R as intubation and at the end of surgery(P0.05),but the difference was insignificant as extubation(P0.05).Recovery time of spontaneous breathing,eye-opening time and extubation time were significantly shortened in Group R(P0.05).Conclusions: Remifentanil-propfol is helpful in stabilizing hemodynamic indexes and shortening analepsia time.