咪唑安定、芬太尼、氨氟醚静吸复合全麻在腭裂整复术中的应用

Application of Intravenous and Inhalational Combined Anesthesia with Midazolam,Fentany 1 and Enflurane in Cleft Palate Repair Operation

目的 :探讨咪唑安定、芬太尼、氨氟醚静吸复合全麻用于腭裂整复手术的效果。方法 :12 8例腭裂患儿采用咪唑安定 0 .2～ 0 .3 m g· kg- 1 、芬太尼 3～ 5μg· kg- 1 、司可林 1～ 2 m g· kg- 1 诱导插管 ,术中氨氟醚和芬太尼维持麻醉的方法 ,行腭裂整复术。观察患儿血流动力学变化及呕吐、呃逆、呛咳的发生率。结果 :1诱导后与术前基础值相比收缩压下降 5 %～ 8% ,舒张压下降 8%～ 10 % (P<0 .0 5 ) ,心率无显著变化 (P>0 .0 5 )。插管后血压与基础值相比无显著性差异 (P>0 .0 5 )。 2诱导后呃逆、呛咳发生率分别为 3 .1%、7.8% ,术毕呕吐率为 7.0 %。 3术毕患儿评分为7± 1分。 4 12 8例患儿术中出血量均低于其总血容量的 5 %。结论 :咪唑安定、芬太尼、氨氟醚静吸复合全麻用于腭裂整复术安全、有效 ,不失为一种较理想的麻醉方法。

Objective: To observe the effects of intravenous and inhalational combined anesthesia with midazolam, fetanyl and enflurane in the cleft palate repair operation.Methods: 128 patients prepared for cleft palate repair operation were selected randomly.Anesthesia was induced with 0.2~0.3 mg/kg midazolam, 3~5 μg/kg fentany 1, and intubation was facilitated with 1~2mg/kg succinylcholine. Anesthesia was maintained with fentany 1 and enflurane, and changs of hemodynamics and incident rates of hiccup, cough and vomit were observed during and after operation.Results: ①After inducing, systolic pressure (SP) was decreased by 5%~8%, diastolic pressure (DP) decreased by 8%~10%(P<0.05), and there were no significant changes in heart rates (HR) P>0.05). After intubation, there were no siginificant changes in SP, DP and HR. ②After induction, the incident rates of hiccup and cough were 3.1% and 7.8% respectively. After operation, the incidente rate of vomit was 7.0%. ③The volume of lost blood was 5% less than the patient's whole blood volume. Conclusion:The anesthetic way is easy to be controlled with few side effects, and patients can revive easily, so it is a safe, efficient and perfect way in cleft palate repair operation.