摘要
目的:探讨七氟醚吸入麻醉在婴儿唇裂术后拆线的可行性。方法:选择年龄小于1岁唇裂术后拆线患儿60例,随机分为氯胺酮肌注组(K),七氟醚吸入组(S)和七氟醚复合笑气吸入组(SN)。K组给予肌注氯胺酮5mg/kg,咪唑安定0.05mg/kg,阿托品0.01mg/kg;S组以8%七氟醚,氧流量6L/min面罩吸入诱导;SN组以8%七氟醚,复合笑气4L/min,氧气2L/min吸入诱导,患儿入睡后改为4%七氟醚,氧流量3L/min维持,吸入2min后开始拆线。术中常规监测患儿HR,SpO2。记录患儿诱导时间、苏醒时间、术中发生体动情况及术中呼吸抑制、分泌物增多等并发症情况。结果:S组和SN组的诱导时间、苏醒时间短于K组,2组间差异无统计学意义。S组和SN组患儿术中体动的发生率小于K组。3组均有患儿发生舌后坠和分泌物增多,但差异无统计学意义。结论:七氟醚吸入诱导和苏醒时间均比肌注氯胺酮麻醉迅速,能够更加安全有效地用于唇裂婴儿术后拆线;复合笑气吸入不能缩短七氟醚吸入麻醉的诱导和苏醒时间。
Objective ：To study the feasibility of using sevoflurane induction in infants＇ removing stitches after cleft lip surgery. Methods ： 60 infants after cleft lip surgery, were randomly divided into three groups ： group K （ ketamine group, n = 20） , group S （ sevoflurane group, n = 20） and group SN （ sevoflurane and nitrous oxide group, n = 20）. Group K were given intramuscular ketaraine 5 rag/kg, raidazolara 0.05 mg/kg and atropine 0.01 mg/kg. Group S were iuduced with inhalation of 8% sevoflurane under 6 L/min oxygen. Group SN were induced with inhalation of 8% sevoflurane under 4 L/min nitrous oxide and 2 L/min oxygen. After induction, anesthesia was continued with inhalation of sevoflurane under 3 L/min oxygen for 2 min before starling removing stitches. HR and SpO2 were monitored regularly during operation. The induction time, recovery time, occurrence of head moving, complication such as respiratory depression and increased secretion were recorded. Results： Induction and recover time in group S and group SN were similar, but faster than that of group K. Head raoviug in group S and group SN were less than that in group K. There happened glossoptosis and inereased secretion in all the three groups, but no differences were found significantly. Conclusion： Inhaled induction of sevoflurane has more rapid induction and recover compared with intramuscular ketanfine, and can be used safely in infants＇ removing stitches after cleft lip surgery. Additional inhalation of nitrous oxide can not shorten infants＇induction and recovery time than sevoflurane inhalation alone.
出处
《实用口腔医学杂志》
CAS
CSCD
北大核心
2008年第6期890-892,共3页
Journal of Practical Stomatology
关键词
七氟醚
氯胺酮
唇裂
婴幼儿
麻醉
Sevoflurane
Ketamine
Cleft lip
Infant
Anesthesia
