七氟醚与氯胺酮应用于小儿扁桃体切除麻醉诱导的对比研究

Compared sevoflurane with ketamine during induction in children with tonsillectomy

目的观察七氟醚与氯胺酮应用于扁桃体切除患儿麻醉诱导时的差异,以求找到更适合扁桃体切除患儿的诱导方法。方法40例行扁桃体切除术患儿,ASAⅠ-Ⅱ级,无慢性疾病、早产史及发育延迟,无神经系统及精神疾患,随机分为A、B两组,每组20例。A组诱导采用肌内注射氯胺酮6～8 mg·kg^-1,阿托品0.01～0.015 mg·kg^-1,待患儿意识消失后开放静脉;B组诱导采用面罩吸入七氟醚,待睫毛反射消失后开放静脉。开放静脉后,所有患儿给予芬太尼2μg·kg^-1,万可松0.8～1.0mg·kg^-1,异丙酚0.2～0.3mg·kg^-1,气管插管。记录各组患儿诱导时间,诱导时的顺从性评分,诱导后分泌物情况及其他不良反应。采用焦虑自评量表测量患儿家长术前1 d及与患儿分离后的焦虑评分。结果B组患儿的诱导顺从性评分、诱导时间及诱导后患儿分泌物重量B组均明显小于A组,P〈0.01。两组患儿家长术前焦虑程度差异无显著统计学意义,P〉0.05。与患儿分离后焦虑程度均显著增高,P〈0.01,且A组显著高于B组,P〈0.05。结论对于行扁桃体切除术的患儿,吸入七氟醚麻醉诱导明显优于肌内注射氯胺酮。

Objective To observe the difference between sevoflurane and ketamine during induction in children with tonsillectomy.Methods 40 children undergoing tonsillectomy were divided into two groups,each group was 20 children.Children in group A were induced by intramuscular injection ketamine.Children in group B were induced by inhalation sevoflurane.Induction time,compliance during induction,amount of secretion,side effect in both groups,and the anxious scale of their parents on the first day before operation and after induction were observed.Results Every index in group B is significantly lower than that in group A,P〈0.01.The anxious scale of their parents are higher after induction than before operation both group A and group B,P〈0.01.Further,the anxious scale are higher in group A than in group B,P〈0.05.Conclusion Sevoflurane was better than ketamine during induction in children with tonsillectomy.