七氟醚吸入复合丙泊酚静脉麻醉在小儿泌尿外科手术中的应用

Application of sevoflurane inhalation combined with propofol intravenous anesthesia in pediatric urology surgery

目的通过七氟醚与丙泊酚静吸复合麻醉与单纯丙泊酚全凭静脉麻醉在小儿泌尿外科手术中的应用比较,观察其麻醉效果和临床安全性。方法 60例小儿泌尿外科手术患儿,随机分为丙泊酚静脉麻醉复合七氟醚吸入麻醉组(A组,30例)和丙泊酚全凭静脉麻醉组(B组,30例),观察两组麻醉和手术操作时患儿心率(HR)、收缩压(SBP)、舒张压(DBP),记录停药后两组患儿的自主呼吸恢复、拔管时间和术后麻醉并发症(术后躁动、喉痉挛、低氧血症)的发生情况。结果 B组患儿在气管插管、切皮以及拔除气管导管时HR、SBP、DBP变化较A组患儿显著,差异有统计学意义(P<0.05)。A组患儿自主呼吸恢复时间为(3.1±1.5)min、拔管时间为(5.5±2.3)min,均短于B组患儿的(8.3±2.7)、(10.4±4.4)min,差异有统计学意义(P<0.05)。A组患儿烦躁0例,B组患儿烦躁5例,两组患儿比较差异有统计学意义(P<0.05);两组患儿均未发生低氧血症、喉痉挛。结论小儿泌尿外科手术中采用丙泊酚静脉麻醉复合七氟醚吸入麻醉,术中患儿生命体征更稳定,麻醉苏醒更快更平稳,术后无明显并发症,更适于该类手术。

Objective To observe the anesthesia effect and clinical safety of sevoflurane and propofol intravenous inhalation compound anesthesia and total intravenous anesthesia with simple propofol in pediatric urology surgery.Methods A total of 60 pediatrics with urology surgery were randomly divided into propofol intravenous anesthesia combined with sevoflurane inhalation anesthesia group（group A,30 cases） and total intravenous anesthesia with propofol group（group B,30 cases）.Observation were made on heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP） during anesthesia and operation,and record were made on spontaneous respiratory recovery,extubation time and occurrence of postoperative anesthesia complications（postoperative agitation,laryngeal spasm,hypoxemia） after discontinuation in two groups.Results Group B had significantly higher changes of HR,SBP and DBP in tracheal intubation,skin incision and tracheal extubation than those in group A,and the difference had statistical significance（P〈0.05）.Group A had spontaneous respiratory recovery time as（3.1±1.5） min,extubation time as（5.5±2.3） min,which were all shorter than（8.3±2.7） and（10.4±4.4） min in group B,and their difference had statistical significance（P〈0.05）.Group A had 0 dysphoria case,which was 5 cases in group B,and their difference had statistical significance（P〈0.05）.Both groups had no cases of hypoxemia and laryngeal spasm.Conclusion With combined propofol intravenous anesthesia and sevoflurane inhalation anesthesia in pediatric urology surgery,the vital signs of children are more stable,and the anesthesia recovery is faster and more stable.There are no obvious complications after operation,so it is more suitable for such surgery.