关键词: 舒芬太尼, 儿童, 瑞芬太尼, 芬太尼, 扁桃体和腺样体切除术

Abstract: Objective To investigate different anesthetic effects of remifentanil, sufentanil, and fentanyl in the pediatric tonsilloadenoiectomy. Methods Totally 210 cases of tonsilloadenoiectomy enrolled in our institution from March 2016 to February 2017 were selected as study objects. Children were divided randomly into three groups, with 70 cases in each group, including remifentanil group, sufentanil group, and fentanyl group. Child patients in the remifentanil group were induced by remifentanil with 1 mg/kg, and were maintained with 0.1 mg·kg-1·min-1. Remifentanil was withdrawn 5 minutes before the end of operation. Child patients in the sufentanil group were induced by sufentanil with 0.2 mg / kg, and were maintained with 0.1 mg·kg-1·h-1. Sufentanil was withdrawn 30 minutes before the end of operation. Child patients in the fentanyl group were induced by fentanyl with 2 mg/kg, and were maintained with 1 mg·kg-1·h-1. Fentanyl was withdrawn 30 minutes before the end of operation. During the anesthesia, the indexes of heart rate (HR), mean arterial pressure (MAP), and oxygen saturation were recorded in the three groups. The time of eyelash reflex disappearance, pain reflex disappearance, postoperation eye open, and extubation were also recorded. The incidences of perioperative adverse events were compared between the three groups. Results HR and MAP at time points of anesthesia induction, 5 minutes after anesthesia induction, and 10 minutes after anesthesia induction were higher in the remifentanil group than those in the other two groups (P＜0.05). And the differences of the above indexes at all time points between sufentanil group and fentanyl group showed no statistical significance (P＞0.05). The time of pain reflex disappearance, postoperation eye open, and extubation were higher in the fentanyl group than those in the other two groups (P＜0.05). And the differences of the above indexes between sufentanil group and remifentanil group showed no statistical significance (P＞0.05). Incidence rate of postoperative  agitation was higher in the remifentanil group than that in the other two groups (P＜0.01). And the difference of incidence rate of postoperative agitation between the sufentanil group and fentanyl group showed no statistical significance (P＞0.05).Conclusion The effect of sufentanil is better than remifentanil and fentanyl in the anesthesia of pediatric
tonsilloadenoiectomy, with fast effect, fast analepsia, stable haemodynamics, and low incidence rate of postoperative agitation.

Key words: sufentanil, remifentanil, fentanyl, child, tonsilloadenoiectomy