Application Of Two Anesthetic Methods Infant Cleft Lip And Palate Surgery

Objective To compare the anesthesia effects of sevoflurane and propofol combined remifentanil on induction or maintain,of anesthesia, postoperative recovery and complications in infants cleft lip and palate prothesis.Methods Selected60infants with oral and maxillofacial cleft lip surgery. They were28boys and32girls and aged3to12months, including cleft lip in children48cases,12cases of children with cleft palate. According to American Society of Anesthesiologists (ASA), the infants were Ⅰ-Ⅱ grade and their weight were greater than5kg, hemoglobin (HGB)>100g/L, white blood cells count (WBC)<10.0×109/L, without heart and lung, liver and kidney disease, and nerve mental disorders. They were divided into two groups (n=30) randomly, one group was propofol combined remifentanil anesthesia (P-R group), the other was sevoflurane combined remifentanil anesthesia (S-R group). The hemodynamic changes of infants in two groups were observed and compared at the time of before induction (T1), intubation (T2), after the intubation (T3), after intubation5min (T4), the start of surgery (T5), after surgery15min (T6) and awake extubation (T7). The time of awareness disappearance, recovery time of spontaneous breathing and the extubation time were recorded. The postoperative respiratory secretions, restlessness, nausea and vomiting were observed. All infants were forbidden to eat and drink as the routine. In order to exclude the effects of atropine on heart rate, all infants were unused atropine before surgery.Results During the surgery, the hemodynamic of S-R group was stable, but that of P-R group varied greatly in surgery. The difference between two groups was statistically significant (P<0.05). The time of awareness disappearance, recovery time of spontaneous breathing and extubation time in S-R group were almost the same as that of P-R group. The difference between two groups was no statistically significant (P>0.05). The postoperative agitation of S-R group was4cases (13%) and that of P-R group was3cases (10%) and they were no significant difference (P>0.05). The postoperative respiratory secretions increased and that of P-R group were24cases (80%) and6cases (20%) in S-R group. They were statistically significant (P<0.05).Conclusion Sevoflurane combined remifentanil anesthesia can be used in infants cleft lip and palate prothesis safely and effectively. Compared with propofol combined remifentanil anesthesia, their hemodynamic is more stable and complications are less. Objective We compared with haemodynamics and awake grade influence to children by intravenous infusion remifentanil complexed propofol and ketamine complexed propofol by micro pump in children cleft lip repair.Methods We choosed600cases children withcleft lip whose old were3to12months and ASA were Ⅰ to Ⅱ grad. We divided remifentanil complexed propofol group(R group) and ketamine complexed propofol group(K group) in random. Every group has300cases. After anesthesia induction rout, R group was anesthetized by intravenous infusion remifentanil complexed propofol and K group was anesthetized by ketamine complexed propofol. Two groups were band snuff air tube with reserve air bag and remained spontaneously breathing. All drugs were stopped5minutes before the end of the operation. In operation, blood pressure(BP), heart rate(HR), respiration rate(RR), saturation of blood oxygen(SP02), tease tube time and awake grade were recorded.Results BP HR were higher K group than R group in operation. Awake grade and tease tube time were longer K group than R group. There was a significant difference(P<0.05). However, RR and SPO2were not significant difference.Conclusion The method of intravenous infusion remifentanil complexed propofol by micro pump was better in children cheilognathus prothesis operation.