三种麻醉方法在小儿气管内异物取出术中应用的比较

Application of Comparison on Removal of Tracheal Foreign-body with Three Different Anesthetic Methods in Children

目的:探讨小儿异物气管取出术的麻醉方式。方法:将188例气管异物取出术患儿分成3组,Ⅰ组:静脉注射丙泊酚;Ⅱ组:面罩吸入七氟醚;Ⅲ组:静脉注射丙泊酚,同时给予面罩吸入七氟醚。分别记录各组术前诱导时间,术中脉搏氧饱和度(SPO_2),气管插管时有无呛咳,术毕患儿苏醒时间,苏醒后有无烦躁等。结果1.Ⅰ组、Ⅱ组、Ⅲ组的术前诱导时间及术后苏醒时间均有显著差异(P<0.05),经组间比较发现术前诱导时间Ⅰ组较快,术后苏醒时间Ⅱ组较Ⅰ组、Ⅲ组明显缩短,其差异具有统计学意义(P<0.05)。2.3组不同麻醉方式的呛咳、屏气发生率及苏醒后烦躁发生率具有显著差异(P<0.05),但SPO_2<90%的发生率无明显差别(P>0.05)。结论实际工作中,以静脉注射丙泊酚同时吸入七氟醚,并辅助1%利多卡因咽喉部表面麻醉保留自主呼吸的方式为首选,即可保证患儿的生命安全又可确保手术顺利进行。

Objective To analyze the management of anesthesia for children undergoing foreign - body aspiration from the bronchus.Method 188 cases will be divided into three groups.In group I,intravenous propofol.In groupⅡ,inhale sevoflurane by masks,in groupⅢ,anesthesia was induced with a combination of propofol and sevoflurane.Narcotic induction time,intraoperative pulse oxygen saturation,cough during tracheal intubation, postoperative revive time and dysphoria after revive were recorded respectively.Results 1.Significant differences could be found,when comparing the narcotic induction time and postoperative revive time in three different anesthetic methods.（P 0.05） Narcotic induction time of groupⅠwas the fastest,while the postoperative revive time in groupⅡwas shorter than that in groupⅠand groupⅢ.（P 0.05） 2.The incidence of cough and dysphoria has significant difference in Three groups of different way of anesthesia（P 0.05）,but the incidence of SPO_2 90%has no obvious difference.（P0.05） Conclusion In the clinical work,we first select the anesthesia which was induced with a combination of propofol and sevoflurane,and then auxiliary 1%lidocaine throat surface anaesthesia retain independent breathing patterns,those will ensure a safe procedure of operation.