七氟烷复合舒芬太尼在门诊小儿包皮环切手术中的应用

The clinical observation in circumcision for children in out-patient clinic with sevoflurane complex sulfentanil anesthesia

目的观察七氟烷联合舒芬太尼用于门诊小儿包皮环切手术的临床效果。方法60例ASAⅠ-Ⅱ级行包皮环切手术的门诊患儿，年龄3—7岁，随机分为A，B两组。所有患儿均给予浓度8％七氟烷面罩吸入诱导，患儿入睡后，开放静脉，手术开始前，A组给予舒芬太尼0．2μg／kg慢推，B组患儿予氯胺酮2mg／kg，术中A、B组均吸入3％-5％七氟烷维持麻醉。采用SPSSl3．0软件包进行统计学分析。结果①B组出现T2-T5时段的MAP升高，HR增快（P〈0．01）；A组T1～T5时段MAP、HR水平稍增加，没有显著性差异，（P〉0．05）；②术后停药到苏醒的时间，B组大于A组，有显著性差异。（P〈0．01）；③A组患者术后躁动和恶心呕吐发生率明显低于B组（P〈0．01）。呼吸抑制两组均未发生。结论七氟烷联合舒芬太尼用于门诊小儿包皮手术具有术后苏醒过程平稳，舒适，不良反应少的优点。

Objective To observe the clinical effect of circumcision for children in out-patient clinic with sevoflurane complex sulfentanil anesthesia. Methods Sixty scheduled children to be accepted circumcision from 3 -7 years old were selected and divided into two groups randomly. Sevoflurane was used in induction and anesthesia maintain in all the children. Group A was injected sulfentanil 0. 2 μg/kg and group B was injected ketamine 2 mg/kg. SpO2, HR and MAP before induction （ T0 ）, five minutes （ T1 ） after induction, operate beginning（ T2 ）and the end（ T3 ） , ten minutes（ T4 ） , twenty minutes （T5 ）after operate, the recovery time and the ratio of postoperative nausea and vomiting, delirium were recorded. Results （1）MAP and HR increased when the operate began in group B （ P 〈 0.01 ） , and there were no significant difference in all the time in group A （ P 〉 0. 05 ）. （2）There were significant difference in recovery time after operation in both groups, the time of group B is longer than group A （ P 〈 0. 01 ）. （3）The ratio of restlessness, postoperative nausea and vomiting in group A much lower than in group B after operation （ P 〈 0. 01 ） , and there were no respiratory depression observed in both groups. Condusion Sevoflurane with sulfentanil has benefits as rapid recovery, few respiratory depression, good pain relief and few complications in circumcision for children in out-patient clinic.