七氟醚诱导对患儿镇静和循环的影响

Effect of sevoflurane on sedation and circulation of neonates

目的研究七氟醚吸入诱导对患儿循环、镇静深度的影响。方法45例择期行腹部手术患儿随机均分为A、B、C组,分别吸入4%、6%、8%七氟醚麻醉诱导,观察体动消失时间、插管时间、诱导期不良反应和插管条件评分,记录入室时(T1)、诱导后30s(T2)、插管前即刻(T3)、插管后即刻(T4)MAP、HR、SpO2和脑电双频指数(BIS)。结果C组体动消失时间和插管时间最快(P<0.05),诱导后循环系统的抑制程度最大(P<0.05),诱导中不良反应最多;插管前后A组的MAP波动最大(P<0.05);A组插管条件评分最高。结论七氟醚对患儿镇静程度和循环呈剂量相关性抑制,临床推荐吸入诱导浓度为6%。

Objective To study the effects of inhalational induction with sevoflurane on the depth of sedation and circulation in neonates. Methods Forty-five neonates undergoing selective abdo- minal operation were randomly divided into three groups of anesthesia induction with 4% （group A）, 6%（group B） and 8% （group C） sevoflurane inhalation. The times of loss of automatic action and tracheal intuhation were recorded. The incidence of adverse effects and the quality of tracheal intubation were assesed. MAP, HR,SpO2, bispectral index （BIS） were observed on arrival（T1 ）, at 30 s after induction （T2）,the moment before intubation（T3） and after intubation（T4 ）. Results Among three groups, the times of loss of automatic action and tracheal intubation of group C were the shortest,the circulatory depression of group C was the most, and the incidence of adverse effects of group C was the highest, the circulatory fluctuation of group A was the bigest, the condition for intubation of group B was the best. Conclusion The sedation and depression of sevoflurane inhalation are in a concentration-dependant manner. 6% Sevoflurane inhalation is recomanded for anesthesia induction of neonates.