摘要
目的:以50%和95%小儿平稳拔除喉罩的呼气末七氟烷浓度(EC50和EC95)为指标确定拔除喉罩的麻醉深度,并观察1%丁卡因润滑剂对小儿拔除喉罩麻醉深度的影响。方法:选择全麻下行单侧腹股沟斜疝修补手术的小儿患者50例,ASAⅠ级,年龄2～5岁,体重10～20kg,随机分为两组(n=25),观察组喉罩表面涂抹含1%丁卡因的液体润滑剂,对照组喉罩表面涂抹不含局麻药的水溶性润滑剂。吸入七氟烷和氧化亚氮诱导并维持麻醉,术中不使用肌肉松弛剂及静脉麻醉药物,手术结束后维持设定的七氟烷浓度15min后拔除喉罩。根据Dixon序贯法确定拔除喉罩的七氟烷浓度,每0.2%七氟烷浓度为一个增减单位。拔除喉罩时患儿没有出现咳嗽、牙关紧闭、体动、屏气及喉痉挛等认为平稳拔除喉罩。结果:观察组患儿平稳拔除喉罩的呼气末七氟烷EC50值为1.23%(95%CI1.11%～1.34%),EC95值为1.46%(95%CI1.34%～2.34%);对照组患儿平稳拔除喉罩的呼气末七氟烷EC50值为1.73%(95%CI1.61%～1.88%),EC95值为2.01%(95%CI1.86%～3.07%)。结论:喉罩表面涂抹1%丁卡因润滑剂后,小儿平稳拔除喉罩的呼气末七氟烷EC50和EC95值分别下降了28.9%和27.4%。
Objective To investigate the effects of 1% tetracaine lubricant on the depth of anesthesia that is determined by the EC50 and EC95 values of sevofurane in the reposeful removal of laryngeal mask airway （LMA） in children. Methods Fifty ASA I pediatric patients aged 2 - 5 years undergoing unilateral inguinal hernioplasty were randomly assigned to receive a LMA with either lubricant containing 1% tetracaine （experimental group） or lubricant alone （control group） on its surface. Only mixed inhalation of sevoflurane and 50% nitrous oxide was administered for induction and maintenance of anesthesia. The target concentration of sevoflurane was maintained for 15 min postoperatively and then LMA was removed. Each target concentration at time of removal was predetermined by the Dixon＇s up-and-down method, with 0.2% sevoflurane as an adjusted unit. The removal of LMA was considered successful when no coughing, teeth clenching, restlessness, breath holding, or laryngospasm occurred. Results The EC50 value of sevoflurane in the reposeful removal of LMA was 1.23% in the experiment group （95%CI 1.11% -1.34%） and 1.73% in the control group （95%CI 1.61% - 1.88%） while the EC95 value was 1.46%（95%CI 1.34% - 2.34%） and 2.01%（95%CI 1.86% - 3.07%）, respectively. Conclusion Application of 1% tetracaine lubricant on LMA reduces the EC50 and EC95 values of sevoflurane by 28.9% and 27.4% respectively in the removal of LMA.
出处
《实用医学杂志》
CAS
2008年第10期1798-1800,共3页
The Journal of Practical Medicine
关键词
丁卡因
儿童
七氟烷
喉罩
麻醉深度
Tetracaine Child Sevoflurane Laryngeal mask airway Anesthesia depth
