新生儿七氟醚麻醉下无肌松剂行腹腔镜手术的临床观察

Clinical Observation of Newborns with Laparoscopic Surgery under Sevoflurane Inhalation Anesthesia without Muscle Relaxant

目的探讨七氟醚维持麻醉下新生儿无肌松剂行腹腔镜手术的可行性。方法选择我院择期在七氟醚麻醉下行腹腔镜腹部手术的新生儿80例,随机分为无肌松组和肌松组,对两组术中呼吸、循环及拔管情况进行监测。结果术中七氟醚浓度无肌松组为(2.2±0.6)%,肌松组为(1.9±0.5)%,差异有统计学意义(P<0.05);气腹后5 min时血压无肌松组为(40.6±4.7)mmHg,肌松组为(44.3±5.6)mmHg,差异有统计学意义(P<0.05)。肌松组的气管导管拔除时间长于无肌松组,但差异无统计学意义(P>0.05)。结论新生儿在无肌松剂的条件下使用七氟醚诱导插管可行,但对于七氟醚合并芬太尼麻醉维持下行长时间腹腔镜手术的患者仍应合理使用肌松剂。

Objective To explore the feasibility of newborns with laparoscopic surgery under Sevoflurane inhalation anesthesia without muscle relaxant.Methods Eighty newborns who were to undergo laparoscopic surgery under Sevoflurane inhalation anesthesia,were randomly divided into group A with muscle relaxant and group B without muscle relaxant.Changes of respiration,circulation and tracheal extubation in the two groups were monitored.Results The Sevoflurane concentrations were （2.2 ± 0.6）％ in group A and （1.9 ± 0.5） ％ in group B respectively,and the difference was statistically significant （P ＜ 0.05） ; blood pressure 5 min after pneumoperitoneum was （40.6 ±4.7）mmHg in group B and （44.3 ±5.6）mmHg in group A,and the difference was statistically significant （P ＜ 0.05）.Time to extubation in group A was longer than that in group B,but the difference was not statistically significant （P ＞ 0.05）.Conclusion It is feasible for newborns to undergo surgery induced intubation with Sevoflurane without muscle relaxant,but muscle relaxant should be considered for patients with long-term laparoscopic surgery under Sevoflurane and Fentanyl inhalation anesthesia.