摘要
【目的】观察丙泊酚与依托咪酯麻醉用于小儿腺样体增生减容术的有效与安全性。【方法】选择本院40例3～7岁准备行腺样体增生减容手术的患儿，随机分为两组，丙泊酚组（P组）与依托咪酯组（E组），每组20例。监测患儿入睡时间、警觉与镇痛评分（OAA／s）5级持续时间、清醒时间、术前、诱导后、手术开始、术毕和术后5min各时点心率（HR）和平均动脉压（MAP）的变化，并对血液动力学指标进行分析比较。【结果】两组患儿术中OAA／S均为4～5级，且入睡时间相比较无统计学意义。两组OAA／S分级中5级持续时间和清醒时间相比较差异无显著性（P〉0．05）。在麻醉诱导结束后5minP组的MAP明显低于E组，HR较E组快，且两组相比较差异有显著性（P〈0．05），术后5minP组的MAP与E组相比较差异无显著性（P〉0．05）。术后E组4例出现恶心呕吐，占20％，P组1例，占5％，两组相比较差异无显著性（P〉0．05）。【结论】丙泊酚与依托咪酯用于小儿腺样体增生减容术均安全可靠，但丙泊酚更有利于术后平稳清醒及拔管。
[Objective]To observe the efficacy and safety of propofol and etomidate anesthesia for volume reduction surgery in children with adenoid hyperplasia. [Methods] Totally 40 pediatric patients（aged 3- 7 years old） scheduled for volume reduction surgery of adenoid hyperplasia in our hospital were randomly divided into propofol group（group P, n =20） and etomidate group（group E, n =20）. The time to fall asleep, the du- ration of 5 grades of alertness/analgesia score（OAA/S）, consciousness time, heart rate（HR） and mean arteri- al pressure（MAP） before surgery, after induction, the beginning and end of surgery and 5min after surgery were monitored. Hemodynamic parameters were analyzed. [Results]Intraoperative OAA/S of patients in two groups was grade 4 to 5, and there was no significant difference in the time to fall asleep between two groups. There was no significant difference in the duration and consciousness time at grade 5 of OAA/S between two groups（ P 〉0.05）. MAP in group P 5min at the end of anesthesia induction was obviously lower than that in group E, and HR in group P was faster than that in group E, and there were significant differences between two groups（ P d0.05）. There was no significant difference in MAP 5min after surgery between group P and group E（ P 〉0.05）. Nausea and vomiting after surgery occurred in 4 patients of group E（20%） and 1 patient of group P（5 %）, but there was no significant difference between two groups（ P 〉 0.05）. [Conclusion]Both propofol and etomidate for volume reduction surgery in children with adenoid hyperplasia are safe and reliable, but propofol is more conducive to the stability, consciousness and extubation after surgery.
出处
《医学临床研究》
CAS
2013年第3期542-544,共3页
Journal of Clinical Research
