靶控输注丙泊酚用于肥胖患儿外伤性白内障手术的临床观察

Clinical observation on target-controlled infusion of propofol during traumatic cataract operation in obese children

目的:观察丙泊酚靶控输注在肥胖患儿外伤性白内障术中麻醉并发症的发生情况,并探讨其防治方法。方法:按体质指数分别选择肥胖患者(肥胖组)和正常体重患者(正常体重组)各30例。两组均给予靶控输注丙泊酚麻醉,记录两组患儿循环呼吸变化、手术时间、麻醉时间、术者对麻醉满意度的主观评价,离开手术室时苏醒程度评分,术中及苏醒后出现的并发症。结果:与正常体重组相比,肥胖组手术时间、麻醉时间均明显延长(P<0.05),术者对麻醉满意度的主观评价及离开手术室时苏醒程度评分偏低,且呼吸系统并发症的发生率明显增加(P<0.05),其余指标无统计学差异。结论:肥胖患儿丙泊酚靶控输注中容易发生呼吸道并发症,且苏醒时间延长,因而要加强呼吸道的管理。

Objective： To observe the anesthetic complications of target - controlled infusion of propofol during traumatic cataract operation in obese children, explore the prevention and treatment. Methods： According to body mass index （BMI）, 30 obese children （obe- sity group） and 30 children with normal body weight （ normal weight group） were selected respectively; anesthesia with target - controlled in- fusion of propofol was performed in the two groups ; the indexes needing to record included circular and breathing changes, operation time, anesthetic time, the subjective assessment of operators to satisfaction of anesthesia, the score of recovery degree when leaving operating room, and complications during operation and after recovery. Results： Compared with normal weight group, the operation time and anesthetic time in obesity group prolonged significantly （P 〈 0. 05 ） . the subjective assessment of operators to satisfaction of anesthesia and the score of re- covery degree when leaving operating room were lower, and the incidences of complications of respiratory system increased significantly （ P 〈 0. 05 ）, there was no statistically significant difference in the other indexes between the two groups. Conclusion： Complications of respiratory system were easily to occur in the course of target - controlled infusion of propofol during traumatic cataract operation in obese children, and the recovery time prolonged; so management of respiratory tract should be enhanced.