Clinical application investigation of remifentanil and fentanyl in pediatric tonsillectomy

Objective:To investigate the effects and safety of remifentanil and fentanyl in pediatric tonsillectomy.Methods:30 patients were randomly divided into remifentanil group(R) and fentanyl group(F).R group administration:ketamine 2 mg/kg,propofol 1mg/ kg,remifentanil 1μg/kg and rocuronium 0.5 μg/kg induced by intubation,to maintain the infusion pump with propofol 4～10 mg/(kg·h) and remifentanil 0.25～0.5 μg/(kg·min);F group administration:ketamine 2 mg/kg,propofol 1mg/kg,fentanyl 3 μg/kg and rocuronium 0.5 μg/kg,induced by intubation with intravenous injection,to maintain the infusion pump with propofol 4～10 mg/(kg·h),intermittent intra-venous injection with funnepal 1 μg/(kg·h).To record SBP,DBP,HR at preoperation,preoperative 1 min and postoperative 1 min,recovery time of spontaneous breathing after operation,calling for eye opening time,extubation time,and postoperative 24h vomiting and nausea.Results:The recovery time of spontaneous breathing after operation,calling for eye opening time and extubation time in R group had statistical difference compared with the F group(P0.05).Hemodynamics before anesthesia was similar in the two groups.HR at 1min before extubation in R group was slower than that in F group(P0.05),and SBP at 1min after extubation was lower than that in F group(P 0.05).The occurrence of postoperative vomiting and nausea had no statistical significance.Conclusion:Remifentanil has better controllability to hemodynamics such as BP,HR,with better analgesic effect of anesthesia,rapid induction and awakening,smooth operation and few adverse reactions,which is worthy to be popularized.