七氟醚吸入麻醉在非住院患儿清创缝合术中的应用

Application of sevoflurane anesthesia in children undergoing day debridement surgery

目的观察七氟醚吸人麻醉在非住院患儿清创缝合术中的应用。方法年龄2～6岁ASAⅠ或Ⅱ级行清创缝合术患儿60例，随机均分为两组：七氟醚组（S组）及氯胺酮组（K组），分别采用面罩吸入七氟醚或肌肉注射氯胺酮进行麻醉诱导及维持。观察并记录两组患儿麻醉中MAP、HR、RR及SpO2的变化，记录意识消失、苏醒及麻醉恢复室（PACU）停留时间，观察并随访麻醉中及麻醉后的不良反应。结果S组患儿术中MAP略有下降，HR无明显变化，而K组术中MAP升高、HR增快（P〈0．05）；S组患儿意识消失时间、苏醒时间及PACU停留时间明显短于K组（P〈0．05）；K组诱导期兴奋、术中体动及分泌物增加的病例数显著多于S组（P〈0．05）。结论七氟醚吸入麻醉诱导迅速、维持平稳、苏醒彻底、循环呼吸影响小、不良反应发生率低、PACU停留时间短，可安全用于非住院患儿清创缝合手术麻醉。

Objective To observe the anesthetic effect of sevoflurane in children undergoing clay debridement surgery. Methods Sixty pediatric patients aged two to six years old with ASA I or II undergoing day debridement surgery were randomly divided into sevoflurane anesthesia （group S） and ketamine anesthesia （group K）. During anesthetic induction and maintenance, the MAP, HR, RR and SpO2 were recorded. The time durations of consciousness, awaking from anesthesia, and stay in the post anesthesia care unit （PACU） were recorded. The side effects during anesthesia were also observed. Results MAP decreased gently in group S, but the MAP and HR were markedly raised in group K （P〈0.05）. The time durations of consciousness, awaking from anesthesia and PACU stay in group S were obviously shorter than those in group K （P〈0.05）. More patients showed exciting during induction, intraoperative restlessness and increased secretion in the respiratory tract in group K than the comparison （P〈0. 05）. Conclusion Sevoflurane can provide a superior anesthetic condition as fast induction, stable maintenance, thorough recovery, less depression on respiration and circulation, shorter stay in the PACU, and less incidence of adverse reactions than that with ketamine. It can be used in pediatric patients undergoing day pediatric debridement surgeries.