摘要
目的观察七氟烷复合氧化亚氮全凭吸入麻醉用于小儿颌面外伤手术的临床效果。方法选40例ASAⅠ～Ⅱ级颌面外伤手术患儿,年龄1～4岁,包括舌部外伤,软腭或硬腭外伤,面部外伤。随机分为2组。K组:给予氯胺酮5mg/kg～8mg/kg肌肉注射+丙泊酚1.5mg/kg+维库溴铵0.1mg/kg～0.15mg/kg静脉注射诱导插管,术中丙泊酚5mg/(kg.h)～10mg/(kg.h)静脉麻醉维持。S组:给予七氟烷8%面罩吸入+维库溴铵0.1mg/kg～0.15mg/kg缓慢静注诱导,术中麻醉维持吸入七氟烷及氧化亚氮和氧气,氧化亚氮1L/min、氧气1L/min,七氟烷1.2～1.5MAC(3%～4%)维持。根据术中血流动力学状况和手术刺激程度,适当调控麻醉深度。采用SPSS11.0软件包进行统计。结果 2组诱导插管均顺利。K组诱导后患儿心率显著增快(P<0.01)、血压下降(P<0.05),插管及术中清创时仍保持较快心率(P<0.01),与S组比较有显著差异(P<0.01)。S组在诱导后患儿心率、血压有所下降(P<0.05),但插管和术中清创时心率血压基本保持平稳。术后S组患儿自主睁眼和拔管的时间显著早于K组(P<0.05),但发生躁动病例多于K组。结论七氟烷复合氧化亚氮麻醉能较舒适、平稳地满足小儿颌面外伤手术要求。
Objective To evaluate the clinical effect of sevoflurane combined nitrous oxide anesthesia for pediatric maxillofacial trauma.Methods Forty American Society of Anesthesiologiests （ASA） physical statusⅠ or ⅡMaxillofacial trauma children aged 1～4 years were randomly divided into two groups of 20 children each. Group K：ketamine＋propofol＋vecuronium group; Group S：sevoflurane＋ vecuronium group. Before intubation,children in group K received ketamine （5mg/kg～8mg/kg） by intramuscular injection and propofol （1.5mg/kg） and vecuronium （0.1mg/kg～0.15mg/kg） by intravenous infusion,and then received propofol 5mg/（kg·h）～10mg/（kg·h） during the maintenance of surgery. In group S,anesthesia was induced by inhalation of 8% sevoflurane and vecuronium （0.1mg/kg～0.15mg/kg） intravenously,was maintained with nitrous oxide 1L/min,oxygen 1L/min and sevoflurane at 1.2～1.5 minimumalveolar concentration （MAC 3%～4%）. According to the change of hemodynamics,the depth of anesthesia was adjusted. SPSS11.0 software package was used for comparison of the differences between the two groups.Results All children finished the process of induction and intubation successfully. HR increased （P0.01） and MAP decreased （P0.05） significantly after induction in group K,and HR kept in faster range compared with that in group S （P0.01） during the intubation and debridement. In group S,HR and MAP had a significant decrease after intubation （P0.01）,but hemodynamics was stable throughout the surgery. During the surgery,SpO2 of both groups consistently maintained in normal range. In group S the time to awake and extubate was earlier than that in group K （P0.05）,but the restlessness was significantly higher.Conclusion Sevoflurane and nitrous oxide can offer superior stable and comfortable surgery in children.
出处
《现代口腔医学杂志》
CAS
CSCD
2010年第3期174-176,共3页
Journal of Modern Stomatology
关键词
全凭吸入麻醉
七氟烷
氧化亚氮
全麻
小儿
Inhalation anesthesia Sevoflurane Nitrous oxide General anesthesia Paediatrics
