术前布地奈德混悬液雾化吸入治疗后对合并上呼吸道感染的小儿喉罩全麻期间呼吸不良事件的影响

The effect of preoperative budesonide nebulizer inhalation on perioperative respiratory adverse events in upper respiratory infection children's laryngeal mask airway anesthesia

目的:评价术前对合并上呼吸道感染(upper respiratory infection,URTI)的小儿应用布地奈德混悬液雾化吸入预处理后,对其喉罩全麻期间的呼吸相关不良事件的影响。方法:选择本院2013年1月至2014年12月期间收治的合并URTI的腹股沟斜疝患儿80例,随机分为试验组(A组)和对照组(B组),对照组进行常规喉罩全麻,试验组则于术前应用布地奈德混悬液雾化吸入预处理后再进行喉罩全麻,观察并比较两组患儿麻醉期间出现的各种呼吸相关的不良事件发生率:SpO_2<9 5%,咳嗽多痰、喉痉挛、支气管痉挛、术后声嘶和屏气的发生率。结果:A组SpO_2<95%,咳嗽多痰、喉痉挛、屏气、支气管痉挛以及术后声嘶的发生率分别为12.5%、10%、7.5%、6%、0%、17.5%;B组分别为37.5%、32.5%、37.5%、17.5%、35%、2.5%。A组SpO_2<95%,咳嗽多痰、喉痉挛的发生率比B组更小差异明显,具有统计学意义(P<0.05);而声音嘶哑、屏气、支气管痉挛的发生率差异不具有统计学意义(P>0.05)。结论:应用布地奈德混悬液雾化吸入预处理对于合并URTI的小儿行喉罩全麻,可以有效地降低麻醉期间与呼吸相关不良事件的发生率。

Objective： To evaluate the effect of preoperative budesonide nebulizer inhalation on perioperative respiratory adverse events in upper respiratory infection （URTI） children laryngeal mask airway （LMA） anesthesia. Methods： In our hospital 80 cases children with URTI undergoing hernia operations during January 2013 to April 2015 were randomly divided into experimental group （group A, n=40） and control group （group B, n=40）. The control group was given conventional LMA anesthesia, the experimental group received budesonide suspension liquid atomization inhalation as pretreatment before LMA anesthesia. The perioperative respiratory adverse events （PRAEs）, such as SpO2 〈95%, cough and phlegmatic, laryngospasm, apnea, bronchospasm, hoarseness were observed and recorded, and the rates were compared between the two groups. Results： The rates of SpO2 〈95%, cough and phlegmatic, laryngospasm, apnea, bronchospasm, hoarseness were 12.5%, 10%, 7.5%, 6%, 0%,17.5% respectively in group A, and 37.5%, 32.5%, 37.5%, 17.5%, 35%, 2.5% in group B. Analysis those data in statistics, the rates of SpO2 〈95%, cough and phlegmatic, laryngospasm were apparently higher in group A （P〈0.05）, and the rates of apnea, bronchospasm, hoarseness were no significant statistical differences. Conclusion： The application of budesonide suspension liquid atomization inhalation as pretreatment to those URTI children who were undergoing LMA anesthesia, could effectively reduce PRAEs.