不同低流量七氟烷麻醉在小儿的应用研究

Effect of different low-flow anaesthesia with Sevoflurane on children

目的探讨不同新鲜气流量对七氟烷吸入小儿麻醉中安全性的影响。方法选择ASAI-II级3～10岁行腹腔镜疝囊高位结扎术小儿90例,随机分为ABC3组,每组30例,全部病例选择七氟烷吸入法诱导,气管插管后2%～3%七氟烷维持,A组小儿术中用新鲜气流量0.3L/min,B组新鲜气流量为0.6L/min,C组新鲜气流量为0.9L/min,连续监测BIS,PETCO2,MBP,HR,ECG,SPO2观察术前,术后24,48h肾功能的变化。结果 3组各组年龄,体重,手术,麻醉时间,MBP,SPO2比较差异无统计学意义(P>0.05);3组不同时点PETCO2有明显差异(P<0.05),A组明显高于B组和C组,3组病例均无肺部并发症及肾功能损害。结论低流量吸入七氟烷麻醉在小儿也是安全可行的。

Objective To explore the effect and safety of different low-flow anaesthesia with Sevoflurane on children.Methods 90 elective surgical children aged from 3 to 10 years undergoing laparoscopic hernia sac ligation operations were randomly divided into 3 groups,group A,group B and group C,30 in each group.All the children were induced and maitained with Sevoflurane.Group A：0.3L/min fresh oxygen flow was infused,at the same time 0.6L/min and 0.9L/min fresh oxygen was used in group B and in group C respectively.BIS,PETCO2,MBP,HR,ECG and SPO2 were monitored during surgery.Venous blood samples were taken at pre-anesthesia,24 h and 48 h after operation for determination of BUN and CRE.Results Significant difference was detected in PETCO2 at ervery moment between three groups.PETCO2 was sigmificantly higher in group A than in group B and group C（P 0.05）.No significant difference was detected in BIS,MBP,HR,ECG,SPO2,BUN and CRE between three groups.All children recoveried without complications in lung and kidney.Conclusion Low-flow anaesthesia with Sevoflurane is safe in children.