七氟醚在小儿外科手术麻醉中的应用

Application of sevoflurane inhalation anesthesia in children

目的评估七氟醚在小儿麻醉的安全性和麻醉效果。方法40例3～10岁手术患儿随机均分为两组,每组20例。S组入室后面罩直接吸纯氧(4L/min)加七氟醚(吸入浓度为8%,维持浓度控制在3%以下)。K组入室予2mg/kg氯胺酮静注,术中以20～50μg·kg-1·min-1维持。两组患儿均在睫毛反射消失后,静注芬太尼2μg/kg和阿曲库铵0.5mg/kg行气管插管。结果两组诱导平稳。K组患儿心率、血压显著高于术前和S组(P<0.05)。S组清醒时间明显快于K组[(8.2±2.4)min vs·(13.7±3.2)min](P<0.01);K组恢复期复睡、躁动、恶心呕吐等总体不良反应高于S组。结论与氯胺酮全麻比较,七氟醚吸入全麻用于小儿短小手术,诱导快,心血管抑制轻,苏醒迅速,不良反应少。

Objective To observe the clinical effects of sevoflurane inhalation anesthesia in children. Methods Forty children aged 3-10 years old were divided randomly into two group S with 20 cases each. Sevoflurane was inhaled（8% sevoflurane in 4 L/min oxygen for anesthesia induction and 2%-3% sevoflurane for the maintenance） in group S. Ketamine was injected intravenously （2 mg/kg for the induction and 20-50μg · kg^-1 · min^-1 for the maintenance） in group K. Fentanyl 2 μg/kg and atracurium 0. 5 mg/kg were injected after loss of eyelash reflex. The MAP, HR, SpO2 % and incidences of excitatory activity movement, nausea and vomiting during recovery were recorded. Results Anesthesia induction of both groups was smooth. Compared with group K, MAP and HR were significantly lower after injected ketamine in group S （P〈0.05）. The awaketime of group S was shorter than that of group K [（8. 2±2.4） min vs. （13.7±3.2） mini （P〈0.01）. The incidences of adverse reaction during recovery in group S was lower than that in group K. Conclusion Compared to ketamine anesthesia, sevoflurane inhaiation has the advantages of rapid induction and recovery, less side effects during recovery.