摘要
目的:探讨舒芬太尼复合七氟烷麻醉对小儿扁桃体手术的影响。方法:选择45例小儿扁桃体切除术患者,ASAⅠ或Ⅱ级,随机分为三组,Ⅰ组采用芬太尼3.0μg/kg,丙泊酚2.0mg/kg,维库溴铵0.1 mg/kg,术中吸入2%的异氟烷麻醉维持,Ⅱ组舒芬太尼0.3μg/kg,丙泊酚2.0 mg/kg,维库溴铵0.1 mg/kg,术中吸入2%的七氟烷麻醉维持,Ⅲ组舒芬太尼0.4μg/kg,丙泊酚2.0 mg/kg,维库溴铵0.1 mg/kg,术中吸入2%的七氟烷麻醉维持,分别记录麻醉前(T0)、插管前(T1)、插管即刻(T2)、插管后1 min(T3)、3 min(T4)、5 min(T5),扁桃体切除前(T6)、切除即刻(T7)、切除后3 min(T8)、5 min(T9)、10 min(T10),手术结束麻醉拔除气管导管后3 min(T11)、5 min(T12)、10min(T13)等时刻病人的血压、心率的变化,麻醉后病人苏醒时间,镇痛效果及不良反应的发生情况等指标。结果:与T0时比较,三组患者麻醉诱导后插管前T1时SBP、DBP明显下降(P<0.05),HR明显减慢(P<0.05)。与T0时比较,T2、T3时SBP、DBP相对稳定无明显变化,T4～T6时SBP、DBP明显下降(P<0.05),而T2、T3、T4时HR明显增快(P<0.05),T5、T6时HR基本恢复麻醉前水平,以T7、T11时SBP、DBP明显升高(P<0.05),T12时,T8、T9、T10、T12、T13时SBP、DBP基本恢复麻醉前水平,T7、T8、T9、T11、T12时HR明显增快(P<0.05);T10、T13时HR基本恢复麻醉前水平。与T1时比较,三组患者在T2～T5时SBP、DBP明显升高(P<0.05),HR明显增快(P<0.05)。与Ⅰ组比较,Ⅱ组T1～T12时SBP、DBP变化差异无统计学意义,而在T1、T4、T5、T6、T9、T10时HR明显减慢(P<0.05),其他时点HR变化差异无统计学意义。与Ⅱ组比较,Ⅲ组T2、T3时SBP、DBP明显降低(P<0.05),其他时点SBP、DBP变化差异无统计学意义;T1～T4、T7、T8、T11、T12时HR明显减慢(P<0.05),但其他时点HR变化差异无统计学意义。与Ⅰ组比较,Ⅱ组、Ⅲ组术后镇痛效果优于Ⅰ组(P<0.05),苏醒时间短于Ⅰ组(P<0.05),不良反应发生少于Ⅰ组(P<0.05);Ⅲ组与Ⅱ�
Objective：To study the effect of sulfentanyl combined with sevoflurane in children operation on tonsils.Methods：Forty five ASAⅠorⅡpatients of operated on tonsils were randomly divided into three groups： group Ⅰ,fentanyl 3.0μg/kg,propofol 2.0 mg/kg,vecuronium bromide 0.1 mg/kg,isoflurane 2% maintenance of anesthesia;group Ⅱ sulfentanyl 0.3μg/kg,propofol 2.0 mg/kg,vecuronium bromide 0.1 mg/kg,sevoflurane 2% maintenance of anesthesia;group Ⅲ sulfentanyl 0.4μg/kg,propofol 2.0 mg/kg,vecuronium bromide 0.1 mg/kg,sevoflurane 2% maintenance of anesthesia;Blood pressure and heart rate were recorded before the induction of anesthesia（T0）、before the intubation（T1）、intubation instantly（T2）、after the intubation 1 minute（T3）、3 minute（T4）、5 minute（T5）、befoer the tonsils to cut（T6）、instantly（T7）、after the tonsils to cut 3 minute（T8）、5 minute（T9）、10 minute（T10）,after the endotracheal catheter to pull out 3 minute（T11）、5 minute（T12）、10 minute（T13）.Results：When compared with T0,three groups of patients after induction of anesthesia before intubation T1,SBP,DBP decreased significantly（P 〈0.05）,HR was significantly slower （P〈0.05）.When compared with T0,T2,T3,SBP,DBP was no significant change in relative stability,T4～ T6 when the SBP,DBP decreased significantly （P〈0.05）,and T2,T3,T4,when HR was faster （P〈0.05）,T5,T6,when HR returned to pre-an-esthetic level to T7,T11,when SBP,DBP was significantly higher （P〈0.05） ,T12,when,T8,T9,T10,T12,T13,when SBP,DBP returned to the level before anesthesia,T7,T8,T9,T11,T12,when HR was faster （P〈0.05）;T10,T13,when HR returned to pre-anesthetic levels. When compared with T1,three groups of patients in the T2～ T5 when the SBP,DBP was significantly higher（P〈0.05）,HR significantly increased（P〈0.05）. Compared with group Ⅰ,Ⅱ group T1～ T12 when the SBP,DBP change was no significant difference,and in the T1,T4,T5,T6,T9,T10,when HR was slower （P〈0.
出处
《牡丹江医学院学报》
2012年第4期8-11,共4页
Journal of Mudanjiang Medical University
基金
黑龙江省卫生厅科研课题(2009-444)
关键词
舒芬太尼
七氟烷
小儿
扁桃体手术
Sulfentanyl
Sevoflurane
Child
Operation on tonsils
