全凭静脉麻醉与静吸复合麻醉用于脑瘫下肢矫形术比较

Comparison of Total Intravenous Anesthesia and Combined Inhalation and Intravenous Anesthesia in Lower Limbs Orthopedics for Patients with Cerebral Palsy

目的比较全凭静脉麻醉下手控辅助呼吸与静吸复合麻醉下机械通气两种不同方法用于脑瘫下肢矫形术的特点。方法将50例择期接受脑瘫下肢矫形术的患者随机分为全凭静脉麻醉组(TIA组)和静吸复合麻醉组(CIIA组),每组25例。TIA组实施全凭静脉麻醉,手控辅助呼吸;CIIA组采用快速静脉诱导,气管插管,吸入及静脉药维持麻醉,机械通气。观察两组患者术后的苏醒时间及恶心、呕吐、躁动的发生情况。结果CIIA组的苏醒时间明显长于TIA组(P<0.01),术后躁动的发生率高于TIA组(P<0.05)。两组患者的恶心、呕吐发生率差异无显著性意义(P>0.05)。结论与静吸复合麻醉相比,全凭静脉麻醉术后恢复快,不良反应少。

Objective To compare the characteristics of total intravenous anesthesia （TIA） with manual assisted ventilation and eombined inhalation and intravenous anesthesia （CIIA） with mechanical ventilation in lower limbs orthopedics for patients with cerebral palsy. Methods 50 patients with cerebral palsy undergoing scheduled lower limbs orthopedics were randomly divided into the TIA group and CIIA group with 25 eases in each group. The patients of the TIA group were treated with manual assisted ventilation. Those of the CIIA group were treated with fast induction, endotraeheal intubation, inhalated and intravenous anesthetics maintaining the anesthesia and mechanical ventilation. The recovery time after operation and post-operative side effects including nausea, vomiting, and psychomotor agitation of all patients were observed. Results The recovery time of the patients in the CIIA group was significantly longer than that in the TIA group （ P 〈0. 01）, and post-operative psychomotor agitation was significantly higher than that in the TIA group （ P 〈0.05）. However, there was no significant difference in nausea or vomiting found between two groups （ P 〉0.05）. Conclusion Patients treated with TIA is easier to recovery and has fewer side effects than those treated with CIIA.