Objective Exploring the application value of low-dose remifentanil and conventional general anesthesia in pediatric upper limb fractures and their impact on stress injury in children. Methods A total of 78 children with upper limb fractures were selected from Jinan Children's Hospital from October 2023 to October 2024. They were randomly divided into a control group and an observation group, with 39 cases in each group. The control group received routine general anesthesia, while the observation group received low-dose remifentanil anesthesia. The clinical indicators of the two groups of children were compared. Results After operation, sensory nerve and motor nerve block time increased, analgesic onset time and recovery time decreased in observation group (P<0.05). IL-13 level and Ramsay sedation score in observation group were higher than those in control group (P<0.05). The levels of physiological stress index, hemodynamic index, TNF-α, CRP, IL-1β, BPS analgesia score and incidence of adverse reactions in observation group were lower than those in control group (P<0.05). Conclusions Compared to conventional general anesthesia, administering low-dose remifentanil anesthesia to children with upper limb fractures can not only significantly shorten their postoperative recovery time, but also greatly improve their analgesic and sedative effects; And this anesthesia method helps to alleviate the inflammatory response of the child's body, effectively improve physiological stress damage, and sub dose remifentanil anesthesia also has high safety
Key words
Subdose remifentanil /
Conventional general anesthesia /
Upper limb fractures in children /
Stress injury
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References
[1] 晋冉. 瑞芬太尼在小儿上肢骨折手术麻醉中的有效性和安全性[J]. 中国医药指南,2022,20(25):81-84.
[2] Li Y,Yu J,Zhang M,et al.Clinical Application of Remifentanil Combined with Sevoflurane in Manual Reduction of Humeral Supracondylar Fracture in Children[J]. Comput Math Methods Med,2022,2022:2410433.
[3] Elhamrawy A,Villalobos MA,Heydinger G,et al.Combined General and Regional Anesthesia for a Patient With Duchenne Muscle Dystrophy With an Implanted Left Ventricular Assisted Device Undergoing Orthopedic Surgery[J]. J Med Cases,2024,15(6):97-101.
[4] Kim CH,Jeong SS,Park SJ,et al.Anti-inflammatory effect of remifentanil in lipopolysaccharide-stimulated amniotic epithelial cells[J]. J Dent Anesth Pain Med,2019,19(5):253-260.
[5] Li X,Wu J,Lan H,et al.Effect of Intraoperative Intravenous Lidocaine on Postoperative Delirium in Elderly Patients with Hip Fracture:A Prospective Randomized Controlled Trial[J]. Drug Des Devel Ther,2023,17:3749-3756.
[6] Ye P,Pan G,Li Y,et al.The role of remifentanil in regulating mitochondrial autophagy in osteoclasts was investigated based on PINK1/Parkin pathway[J]. Cell Mol Biol (Noisy-le-grand),2024,70(7):186-192.
[7] Kim CH,Lee SH,Kim EJ,et al.Effects of remifentanil preconditioning on factors related to uterine contraction in WISH cells[J]. J Dent Anesth Pain Med,2019,19(6):343-351.
[8] Dost B,Taflan MG,Kaya C,et al.Awake Sternal Fixation Using the Ultrasound-Guided Superficial Parasternal Intercostal Plane Block in a Patient With Cervical Spine Fracture[J]. Cureus,2022,14(8):e28618.
[9] Kong M,Tang Y,Tong F,et al.The analgesic efficacy of pericapsular nerve group block in patients with intertrochanteric femur fracture:A randomized controlled trial[J]. PLoS One,2022,17(10):e0275793.
[10] Kokita A,Chaki T,Yamakage M.A case of safe airway management by fiber-optic nasotracheal intubation in general anesthesia in a pediatric patient with Hajdu-Cheney syndrome:a case report[J]. JA Clin Rep,2023,9(1):33.
[11] To M,Kamizato K,Shinzato H,et al.Anesthetic management of ventricular-peritoneal shunt implantation in osteogenesis imperfecta type IIB:A case report[J]. Medicine (Baltimore),2022,101(1):e28483.
[12] 高航. 分析不同剂量瑞芬太尼联合臂丛神经阻滞在上肢骨折术中的麻醉效果[J]. 中国医药指南,2019,17(26):54-55.
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