静脉与吸入全麻复合局麻用于小儿扁桃体手术的效果比较

A Comparison of Intravenous and Inhalation General Anesthesia Compounded with Local Anesthesia in Tonsillectomy in Pediatric Patients

目的比较异丙酚靶控全麻与异氟烷吸入全麻复合局部麻醉用于小儿扁桃体手术的效果。方法选择ASAⅠ～Ⅱ级、年龄6～12岁、择期行扁桃体摘除术小儿40例,随机分为观察组(P)组和对照组(I)。两组采用相同的诱导方法和药物。P组采用瑞芬太尼-丙泊酚靶控输注维持麻醉,I组采用异氟烷吸入维持麻醉,所有患儿术中均辅助扁桃体局部麻醉。观察围术期两组血流动力学变化,自主呼吸恢复、气管拔管和清醒时间,苏醒后躁动和恶心呕吐的发生率,以及清醒后疼痛评分。结果P组患者麻醉术中循环波动小,苏醒及清醒快,恶心呕吐及苏醒期躁动的发生较I组少。结论瑞芬太尼-异丙酚靶控全麻复合局麻更适合小儿扁桃体摘除手术。

Objective To compare the benefit of target controlled infusion（TCI） anesthesia with propofol with isoflurane inhalation anesthesia compounded with local anesthesia in tonsillectomy in pediatric patients. Methods Fourty children（ASA Ⅰ - Ⅱ , age 6- 12y）undergoing tonsillectomy were randomly allocated to group P （n= 20,anesthesia with propofol and remifantil） and group Ⅰ （n=20, anesthesia with isoflurane）. Anesthesia induction methods for all patients were alike. Anesthesia was maintained with remifentanil and propofol in group P and with isoflurane in group Ⅰ. All patients was administrated with tonsil local anesthesia. Perioperation hemodynamics,time of breath recovery and extubation and awake,restlessness and nausea and pain score within recovery period were recorded. Results Hemodynamic change,incidence rate of restlessness and nausea,and pain score in group P were all less than group Ⅰ. Conclusions Propofol TCI with remifentanil compounded with local anesthesia was more suitable for tonsillectomy in pediatric patients.