4%和8%七氟醚复合不同氧流量麻醉诱导在患儿气管插管中的比较

The comparison of the intubating conditions with different concentration of sevoflurane and different oxygen flow in children

目的比较4%和8%七氟醚复合不同氧流量麻醉诱导在患儿气管插管中的应用效果,同时用Gas Man(ver.4.1)软件模拟吸入诱导2min内患儿脑内七氟醚浓度的变化。方法择期泌尿外科手术患儿80例,年龄1～6岁,均行全凭七氟醚吸入诱导后插管,患儿随机均分为四组,其中S4F4组和S4F8组吸入4%七氟醚,S8F4组和S8F8组吸入8%七氟醚,S4F4组和S8F4组氧流量为4L/min,S4F8组和S8F8组氧流量为8L/min。记录插管时间、插管评分、插管前呼气末七氟醚浓度。运用GasMan软件计算吸入诱导后30、60、90、120s时脑内七氟醚浓度。结果所有患儿均一次插管成功。S4F4组和S4F8组插管时间明显长于S8F4组和S8F8组(P<0.05)。诱导后30、60、90、120s,S8F4组和S8F8组脑内七氟醚浓度明显高于S4F4组和S4F8组(P<0.05)。结论 8%七氟醚诱导速度明显快于4%七氟醚,而氧流量对于诱导速度无明显影响,这与Gas Man软件模拟出的脑内七氟醚浓度是一致的。

Objective To compare the intubating conditions with 4~/oo or 8~/00 of sevoflurane and different oxygen flow in children, and computer simulation software as Gas Man （ver. 4. 1） simulated the change of the sevoflurane concentration in brain for two minutes after induction. Methods Eighty ASA I or II children, aged 1-6 years old, undergone selective urinary surgery under induction and intubation with sevoflurane were enrolled in the study. Patients were randomly divided into four groups, $4F4 group and 84F8 group..4~/0 sevoflurane;SlF4 group and $8F4 group： 4 L/min of the oxygen flow; $8F4 group and $8F8 group= 8~/00 sevoflurane; 84F8 group and $8F8 group： 8 Ijmin. We recorded intubation time, the score of tracheal intubation, CmSev before intubation. The concentraction of sevoflurane in brain could be performed by Gas Man at 30,60,90,120 s after induction. Results All children were intubated successfully at first tim〈 The intubation time was （277.5±25.7） s in $4F4 group, （272. 5~25.0） s in $4F8 group, （186. 4±21.7） s in S8F4 group and （191.9±32.5） s in $8F8 group. There were significant differences between 84F4 and $4F8 groups, 88F4 and $8F8 groups in intubation tim〈 The sevoflurane concentration in brain was higher in S8F4 group than $4F4 group,and in 88F8 group than 84F4 group by Gas Man analysis. Conclusion 80% sevoflurane can make the intubating time shorter than 40% sevofluran〈 There is no significant difference in induction for intubation between 4 L/n-fin oxygen flow and 8 L/min oxygen flow, matching with the brain sevoflurane concentration simulated by computer.