摘要
目的比较七氟醚复合不同浓度氧化亚氮对麻醉苏醒期躁动的影响。方法将择期行全麻下唇裂修补术的45例患儿随机分为S组、N1组、N2组,每组15例,ASA分级Ⅰ级。分别采用七氟醚复合纯氧(S组)、七氟醚复合50%氧化亚氮(N1组)、七氟醚复合66%氧化亚氮(N2组)诱导与维持,手术操作结束后,继续分别给予纯氧(S组)、50%氧化亚氮氧气复合(N1组)、66%氧化亚氮氧气复合(N2组)吸入至七氟醚停后2 min。记录各组睫毛反射消失时间、插管时间。观察术前、插管时、拔管时、拔管后5 min的HR、MAP、Sp O2、BIS值、M AC值。观察拔管后患儿躁动程度,并进行评分。患儿送PACU后采用PAED评分评价患儿躁动发生情况,记录围手术期不良反应。结果 N2组睫毛反射消失时间和插管时间短于S组、N1组(P<0.05),N2组术后即刻躁动评分PACU后PAED评分均低于其他两组(P<0.05)。结论与七氟醚复合纯氧和复合50%氧化亚氮相比,七氟醚复合66%氧化亚氮能缩短插管诱导时间,有效降低躁动程度,并能安全应用于幼儿麻醉。
Objective To compare the effects of sevoflurane combined with different concentrations of nitrous oxide on emergence agitation after anesthesia. Methods Forty-five ASA Ⅰ children underwent cleft lip repair surgery were randomly divided into group S,group N1 and group N2 with 15 cases in each group. Children were respectively given sevoflurane combined with pure oxygen （ group S ） , sevoflurane combined with nitrous oxide （ 50%） （ group N1）,sevoflurane combined with nitrous oxide （66%） （group N2） induction and maintenance. After operation,the children did not receive the pure oxygen （group S）,50% nitrous oxide in oxygen （group N1）,66% nitrous oxide in oxygen （group N2） till 2 min after sevoflurane inhalation stopped. The time from the beginning of drug injection to the loss of eyelash reflex and the intubation time were recorded. The HR,MAP,SpO2 ,BIS value,MAC value were recor-ded before operation,at the time points of intubation,extubation and 5 min after extubation. The degree of agitation was evaluated to record the score. The PAED score was used to evaluate the agitation of children in PACU. The periopera-tive adverse reactions were observed. Results The time from the beginning of drug injection to the loss of eyelash re-flex and the intubation time in group N2 were less than those of group S and group N1 （ P 〈0.05 ） . The immediate postoperation agitation score and the PAED score of children in PACU in group N2 were less than those of the other groups （ P 〈0.05 ） . Conclusion Compared with sevoflurane and sevoflurane combined with 50% nitrous oxide, sevofluranecombined with 66% nitrous oxide can shorten the intubation time,effectively reduce the degree of agitation more significantly,and it is safe for anesthesia of children.
出处
《实用药物与临床》
CAS
2015年第9期1058-1061,共4页
Practical Pharmacy and Clinical Remedies
关键词
七氟醚
氧化亚氮
小儿麻醉诱导
苏醒期躁动
Sevoflurane
Nitrous oxide
Pediatric anesthesia induction
Emergence agitation
