摘要
目的本研究旨在比较分析静吸复合麻醉与全凭静脉麻醉在小儿电子耳蜗植入术中的应用效果和安全性。方法回顾性分析2018年5月—2023年3月择期于南京同仁医院行小儿电子耳蜗植入术的患儿100例,按麻醉方式不同分成静吸复合麻醉(对照组,50例)和全凭静脉麻醉(研究组,50例)。比较2组一般情况、手术前后血流动力学及脑电双频指数(BIS)、术后即时电阻抗、术后躁动率及苏醒时间、术后氧化应激水平以及不良反应发生情况。结果2组年龄,身高,体重,麻醉时间,血流动力学指标(SBP、DBP、HR),BIS比较差异均无统计学意义(P>0.05)。研究组术毕即时电阻抗均低于对照组[低频:(2.57±0.40)kΩvs.(3.93±0.83)kΩ;高频:(7.00±0.31)kΩvs.(8.37±0.42)kΩ,P<0.001]。研究组术后躁动评分和苏醒时间均低于对照组(P<0.001)。2组患者术后氧化应激水平比较差异有统计学意义(P<0.001)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论在小儿电子耳蜗植入术中,全凭静脉麻醉相较于静吸复合麻醉更安全有效。全凭静脉麻醉在术中血流动力学控制、苏醒时间、氧化应激水平以及术后即时电阻抗表现出优势。因此,在临床实践中,应优先考虑全凭静脉麻醉作为小儿电子耳蜗植入术的麻醉方式。然而,麻醉方式的选择仍需根据患者个体情况和麻醉团队的经验进行综合评估。
Objective The aim of this study was to compare the application effectiveness and safety of combined inhalation anesthesia and total intravenous anesthesia in pediatric cochlear implantation surgery.Methods A retrospective analysis was conducted on 100 pediatric patients who underwent cochlear implantation surgery at Nanjing Tongren Hospital from May 2018 to March 2023.They were divided into two groups based on the different anesthesia methods:combined inhalation anesthesia(control group)and total intravenous anesthesia(study group).The differences between the two groups were compared in terms of general conditions,pre-and post-operative hemodynamics and bispectral index(BIS),postoperative immediate electrical impedance,postoperative restlessness and recovery time,postoperative oxidative stress levels,and adverse reactions.Results There were no significant difference in age,height,weight,anesthesia time,hemodynamic indexes(SBP,DBP,HR)and BIS index between the study group and the control group(P>0.05).The immediate electrical impedance at the end of surgery in the study group was lower than that in the control group[low-frequency:(2.57±0.40)kΩvs.(3.93±0.83)kΩ;high-frequency:(7.00±0.31)kΩvs.(8.37±0.42)kΩ,P<0.001].The postoperative sedation-agitation scale(RASS)and recovery time of the study group were lower than those of the control group(P<0.001).There was significant difference in postoperative oxidative stress levels between the two groups(P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Total intravenous anesthesia is a safer and more effective approach compared to combined anesthesia for cochlear implantation surgery in children.Total intravenous anesthesia offers notable benefits in terms of intraoperative hemodynamics control,recovery time,oxidative stress levels,and postoperative impedance.Therefore,total intravenous anesthesia should be considered as the primary option in clinical practice for cochlear implantation surgery i
作者
方响响
鞠学军
姜巧妹
孟玮
何双八
FANG Xiangxiang;JU Xuejun;JIANG Qiaomei;MENG Wei;HE Shuangba(Department of Anaesthesia,Nanjing Tongren Hospital,Southeast University School of Medicine,Nanjing,Jiangsu 211100,China;不详)
出处
《中华全科医学》
2024年第2期191-194,共4页
Chinese Journal of General Practice
基金
国家自然科学基金项目(82171153)
江苏省自然科学基金项目(BK20211012)。
关键词
静吸复合麻醉
全凭静脉麻醉
小儿电子耳蜗植入术
术后即时电阻抗
Combined intravenous anesthesia
Total intravenous anesthesia
Cochlear implantation in children
Immediate postoperative electrical impedance
