七氟醚麻醉诱导与氯胺酮麻醉诱导在患儿全身麻醉中的应用研究

Research of application of induction of anesthesia with Sevoflurane and Ketamine anesthesia induction for children with systemic

目的探讨七氟醚麻醉诱导与氯胺酮麻醉诱导在患儿全身麻醉中的应用效果。方法选取我院2014年1月~2016年1月行全身麻醉手术的腹股沟斜疝患儿82例的病历资料,利用计算机随机分组,对照组41例行氯胺酮麻醉诱导,观察组41例行七氟醚麻醉诱导,监测两组心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2)水平变化,比较两组麻醉诱导时间、哭闹时间、手术时间及术后苏醒时间,并统计两组苏醒期躁动发生情况。结果两组手术前后SpO_2水平比较,差异无统计学意义(P>0.05);观察组T_1、T_2、T_3、T_4时HR、MAP水平均低于对照组(P<0.05);两组手术时间比较不明显,但观察组麻醉诱导时间、哭闹时间及术后苏醒时间分别为(154.92±10.08)、(65.24±6.01)s,(28.31±3.29)min,均短于对照组的(226.45±16.54)、(98.30±8.56)s,(62.18±5.73)min(P<0.05);观察组苏醒期躁动发生率为4.88%,低于对照组的17.07%(P<0.05)。结论在患儿全身麻醉中采取七氟醚麻醉诱导具有起效快、术后苏醒快的特点,同时对呼吸循环影响较小。

Objective To explore the application effects of induction of anesthesia with Sevoflurane and Ketamine anes- thesia induction for children with systemic.Methods 82 cases of children with indirect inguinal hernia and who under- went the systemic general anesthesia operation in our hospital from January 2014 to January 2016 were collected,and they were randomly divided by the computer.In the control group of 41 children were underewent induction of anesthesia of Ketamine,while the observation group of 41 cases were underwent the induction of anesthesia with Sevoflurane. Then,the change level of heart rate（HR）,mean arterial pressure（MAP）,oxygen saturation （SpO2）of two groups were moni- tored,the anesthetic induction time,crying time,operation time and postoperative recovery time were compared between the two groups,and the occurrence of restlessness of two groups was statistically analyzed.Results There was no signifi- cant difference in SpO2 level between the two groups before and after operation （P〉0.05）;the levels of HR and MAP for T1,T2,T3,T4 in the observation group were lower than those in the control group（P〈0.05）;the operation time of the two groups were not obvious,but the anesthesia induction time,crying time and postoperative recovery time in the observation group were （154.92±10.08）,（65.24±6.01）s,（28.31±3.29） min,which were shorter than those in control group （226.45±16.54）,（98.30±8.56） s and （62.18±5.73） min（P〈0.05）;the incidence of restlessness during recovery period in the observation group was 4.88%,which was lower than that in the control group of 17.07%（P〈0.05）.Conclusion The induction of anesthesia with sevoflurane in pediatric with systemic general anesthesia which it has the characteristics of rapid onset and rapid postoperative recovery.At the same time,it has little effect on respiratory cycle.