七氟醚复合喉罩全麻在小儿先天性心脏病封堵术中的应用

Sevoflurance with laryngeal Mask anesthesia in Transcatheter Closure of Congenital Heart Disease of Children

目的比较七氟醚复合喉罩全麻及异丙酚-氯胺酮全凭静脉麻醉在小儿先天性心脏病封堵术的麻醉效果方法80例拟行先天性心脏病封堵术的患儿随机分为A、B两组各50例。A组肌注氯胺酮5～8mg/kg行基础麻醉后采用异丙酚5～10mg/（kg·h）和氯胺酮1-2mg/（kg·h）持续静脉微泵注射维持麻醉,B组面罩半紧闭吸入6%七氟醚,氧流量6L/L,待下颌关节较松弛根据患儿体重置人相应大小的喉罩,七氟醚维持浓度在2%～3%之间。两组患儿术中持续监测心电图、心率、血压及脉氧饱和度,并记录苏醒时间。结果A、B两组患儿血流动力学和SpO2均较平稳,B组麻醉苏醒时间明显短于A组（P〈0.05）,B组术中呼吸抑制及术后恶心呕吐等的并发症发生率较A组低（P〈0.05）,但B组术后烦躁的发生率较A组高（P〈0.05）。结论七氟醚复合喉罩全麻具有麻醉平稳、苏醒快、并发症少的优点,是一种较理想的小儿先天性心脏病封堵手术的麻醉方法。

Objective To compare the effect of genneral anesthesia of sevoflurance with laryngeal mask and propofol compound ketamine in transcatheter closure of congenital heart disease of children Methods Sixty children schedule to undergo transcatheter closure of congenital heart disease, divided into two groups randomly. Group A maintained by 5-10 mg/ （kg.h） of propofol and 1 ~2 mg / （kg.h） ofketamine after 5~8mg/kg of ketamine intramuscular injection , Group B inhaled 6% sevoflurance semi-closed with 6L/min of O2 , inserting suitable LMA aider jaw joints relaxed. Maintanace of sevoflurance was 2%~ 3%. Both groups monitored ECG, HR. BP and SpO2 , recovery time were recorded. Resu Its Both groups had stable hemodynamics and SpO2. Recovery time of group B was significantly shorter than groupA, group B had lower incidence of respiratory depression and PONV but higher incidence of postoperative agitation Conclusion genneral anesthesia of sevoflurance with LMA had advantages of few complications , quickly recovery and stable hemodynamics and SpO2.