面罩吸入七氟醚复合瑞芬太尼在小儿包皮环切术中的效果

Effects of mask inhalation of sevoflurane combined with iv injection of remifentanil in pediatrie circumcision

目的探讨面罩吸入七氟醚复合瑞芬太尼在小儿包皮环切手术中的麻醉效果。方法患儿60例（3-9岁），ASAⅠ～Ⅱ级，随机分为三组，七氟醚组（Ⅰ组）、丙泊酚组（Ⅱ组）和氯氨酮组（Ⅲ组）各20例。Ⅰ组面罩吸入七氟醚，静脉注射瑞芬太尼；Ⅱ组静脉注射瑞芬太尼及丙泊酚，Ⅲ组静脉注射氯氨酮。分别记录三组麻醉手术期间血流动力学的参数、血氧饱和度（SPO2）的变化和麻醉复苏的时间。结果Ⅰ组诱导后和手术时心率、血压基本保持平稳（P〉0．05）。U组在诱导后心率和血压下降较Ⅰ组明显（P〈0．05），且Ⅱ组术中心率和血压波动明显（P〈0．05）。术后患儿自主睁眼和随意运动时间Ⅰ组明显早于Ⅲ组（P〈0．05）。结论面罩吸入七氟醚联合瑞芬太尼在小儿包皮环切手术中的麻醉平稳，效果确切，苏醒快。

Objective To investigate the effects of mask inhalation of sevoflurane combined withiv injection of remifentanil in pediatric circumcision , and to compared with propofol and ketamine. Methods Children with 60 cases （ 3-9years old ）, ASA Ⅰ - Ⅱ grade, were randomly divided into three groups： sevoflurane group （ Ⅰ group ） , propofol group （ Ⅱ group ）, ketamine （ group Ⅲ ） , each group of 20 cases, group Ⅰ was induced with mask inhalation of sevoflurane and iv injection of remifentanil, group Ⅱ were induced with propofol and remifentanil, group Ⅲ were induced with ketamine, recorded separately the hemodynamic parameters and oxygen saturation in anesthesia period, the anesthesia and early recovery time. Results The heart rate and the blood pressure in group Ⅰ maintain steady basically in induction and surgery（ p〉0.05 ）. the heart rate and the blood pressure in group Ⅱ compare Ⅰ group obvious decreased after induction（ P〈0.05 ）.and in surgery the heart rate and blood pressure in group Ⅱ obvious fluctuation （ P〈0.05 ）.the time of opening eyes independently and voluntary movement was obviously earlier in group Ⅰ than in group Ⅲ after the surgery. Conclusion Anesthesia of mask inhalation of sevoflurane combined with remifentanil is stable and effect and recovery quickly in pediatric circumcision