Effects Of Remifentanil And Propoffol Total Intravenous Anestheisa On The Stimulation Of Pediatric Adenotonsillectomy

[Objective] To investigate the effects of remifentanil and propofol total intravenous anesthesia on tracheal intubation, stress response and hydrodynamics, and to observe the characteristics of postoperative recovery on pediatric patients undergoing adenotonsillectomy, so as to find a safe and ideal anesthesia method.[Methods] 30 pediatric patients(5-10 years old, ASA I ) were randomly divided into 3 groups: group R(remifentanil+propofol total intravenous anesthesia), group F(fentanyl+propofol total intravenous anesthesia) and group E(enflurane+propofol combinate anesthesia), each group included 10 cases. We observed the variation of blood pressure, heart rate, oxygen saturation of functional hemoglobin (SPO₂) and the level of corticosteroid and adrenocorticotropic hormone(ACTH) at four time points: 3 minutes before operation(T₁), just after tracheal intubation(T₂), the time when cutting out the gland(T₃) and just after operation(T₄). We also investigated the duration and the characteristics of postoperative recovery.[Results] In group R, compared to T\ , blood pressures at T2, T3, T4 and heart rates at T2 and T3 were decreased(P <0. 05),corticosteroid at T3 and T,, ACTH at T? were decreased, too(P<0.05). In group F, blood pressures at T,, heart rates at T3 and T4 were higher than T, (P<0. 05). Corticosteroid at T2 were raised compared to T, (P<0. 05), while it came to the basic level at L, at T., it became lower than T,(P<0. 05). There were no differences among all the time points on ACTH (P<0. 05). In group E, in comparison to Ti, blood pressures at T2 and T3, heart rates at T2, T:)) and T4 were all markedly increased (P<0.05), while corticosteroid was decreased at T:! and T4 (P<0.05). There were no differences at all the time points in ACTH level. When compared among these 3 groups, there were no differences in corticosteroid level among all the time points, while at T, ACTH in group R was markedly decreased in comparison with group E (P<0. 05). The recovery duration in group R was 5. 6 + 2. 3min, which was faster than group F, 14. 2 + 5. 7min and group E, 23. 1 +9. 6min. There was no fidgetiness during reviving time in group R, but the postoperative pain was more obvious.[Conclusion] On pediatric patients undergoing adenotonsillectomy, remifentanil and propofol total intravenous anesthesia could efficiently restrain harmful stress. They could also maintainhydrodynamic stability, the recovery duration and quality were better,too. This kind of anesthesia method was ideal during pediatricadenotonsillectomy.