Abstract:

Objective  To explore the application effect of remifentanil combined with propofol target-controlled infusion(TCI) to maintain anesthesia in children undergoing tonsillectomy.

Methods  Samples of 85 children with chronic tonsillitis who were treated in Hebei Eye Hospital were selected for retrospective analysis. According to the different anesthesia plans adopted during the operation, they were divided into general anesthesia group and target-controlled anesthesia group. Children in the general anesthesia group received propofol, fentanyl, and atracurium for induction of anesthesia, and children in the target-controlled anesthesia group received remifentanil combined with propofol target-controlled infusion to maintain the anesthesia. The time interval from the end of the operation to extubation, the time to recover spontaneous breathing, and the time to wake up after the operation were compared between two groups of children. Heart rate(HR), mean arterial pressure(MAP) and blood oxygen saturation(SpO2) before anesthesia induction(T1), at the beginning of the operation(T2), at the end of the operation(T3) and at the time of recovery of spontaneous breathing(T4) were compared between two groups. The pediatric anesthesia emergence delirium（PAED） agitation scores of two groups when they were sent to the anesthesia recovery room after the operation, and the OAA/S rating of the children at 5 min after the extubation, and the occurrence of respiratory complications during the recovery period of the two groups of children were compared.

Results  The duration from the end of the operation to the extubation, the recovery time after the end of operation, and the recovery time of the spontaneous breathing of the children in the target-controlled anesthesia group were lower than those in the general anesthesia group(P＜0.05). The differences of interaction between groups, and time points were statistically significant with respect to HR(P＜0.05). The differences of interaction between groups, time points and time points between groups were statistically significant with respect to MAP(P＜0.05). There was a statistical difference in time points between groups in terms of SpO2(P＜0.05). The pediatric anesthesia emergence delirium(PAED) score of children in the target-controlled anesthesia group was significantly lower than that of general anesthesia group(P＜0.05). There was no difference in the number of cases with OAA/S grade 3 and below between two groups(P＞0.05). The incidence of coughing and airway spasm in the target-controlled anesthesia group during the recovery period was significantly lower than that of general anesthesia group(P＜0.05).

Conclusion  Remifentanil combined with propofol target-controlled infusion to maintain anesthesia can help children undergoing tonsillectomy to stabilize hemodynamics, reduce the incidence of postoperative restlessness, promote the recovery of children, and reduce the incidence of respiratory complications.

Key words: tonsillectomy; remifentanil, propofol