低温等离子射频消融小儿扁桃体及腺样体手术的麻醉处理

Anesthesia Handling of Low-temperature Plasma Radiofrequency in the Ablation of Amygdala and Adenoid in Children

目的探究小儿以低温等离子技术消融扁桃体、腺样体,术中不同麻醉管理的安全性。方法该次研究对象为方便选取该院2015年6月—2016年9月期间住院部收治的86例行低温等离子技术消融扁桃体、腺样体治疗的患儿,按入院时间将其分为一般组(术中麻醉维持使用丙泊酚、瑞芬太尼静脉输注复合吸入七氟醚)、观察组(仅使用丙泊酚、瑞芬太尼静脉输注),每组43例,观察患儿苏醒期躁动情况,比较两组麻醉情况(麻醉药用量、拔管时间、出手术室时间)。结果观察组躁动率为7.0%,明显低于一般组18.6%,观察组躁动程度较一般组低(P<0.05);一般组丙泊酚用药量(6.82±0.67)mg/(kg·h)、瑞芬太尼用药量为(10.73±2.45)mg/(kg·h),明显少于观察组(10.05±1.82)、(15.84±4.58)mg/(kg·h),同时观察组患儿出手术室、拔管用时分别为(6.18±0.47)、(8.04±3.65)min,明显短于一般组(12.03±0.86)、(17.47±3.62)min,(P<0.05)。结论临床以低温等离子射频消融小儿扁桃体及腺样体,手术中静脉麻醉患儿躁动发生率低、术后苏醒快,静吸复合麻醉能减少麻醉用量。

Objective To study the effect of low-temperature plasma radiofrequency in the ablation of amygdala and adenoid in children and safety of different anesthesia managements in operation. Methods 86 cases of children with low-temperature plasma radiofrequency in the ablation of amygdala and adenoid admitted and treated in our hospital from June2015 to September 2016 were convenient selected and divided into two groups according to the admission time with 43 cases in each, the general group adopted the propofol, intravenous infusion of remifentanil and inhalation of sevoflurane, the observation group only adopted the propofol and intravenous infusion of remifentanil, and the anesthesia drugs dose, tube drawing time and time to leave the operating room were compared between the two groups. Results The upset rate in the observation group was obviously lower than that in the general group(7.0% vs 18.6%), and the upset degree was lower than that in the general group(P<0.05), and the propofol dose and remifentanil dose in the general group were obviously lower than those in the observation group,[(6.82±0.67),(10.73±2.45)mg/(kg·h) vs(10.05±1.82),(15.84±4.58)mg/(kg·h)], at the same time, the time to leave the operating room and time to tube drawing in the observation group were obviously shorter than those in the general group, [(6.18±0.47),(8.04±3.65)min vs(12.03±0.86),(17.47±3.62)min],(P<0.05). Conclusion In clinic, the low-temperature plasma radiofrequency in the ablation of amygdala and adenoid in children with low incidence rate of upset and rapid recovery, and the intravenous inhalation and anesthesia can reduce the anesthesia dose.