门诊儿童舌系带矫正术三种麻醉方法的对比观察

Comparison of three anesthetic methods for correction of lingual frenulum in out-patient clinic children

目的比较3种不同麻醉方法行门诊儿童舌系带矫正术的临床应用效果。方法 90例舌系带过短患儿,年龄1. 5～4岁,随机分为3组:丙泊酚静脉麻醉组(A组)、七氟醚吸入麻醉组(B组)和七氟醚吸入麻醉复合局部浸润麻醉组(C组),每组30例患儿。结果 3组患儿体质量、性别差异无统计学意义(P> 0. 05)。A组出现3例体动,B组出现2例体动,C组未发生术中体动病例。A组出现1例血氧饱和度(Sp O2)<95%,B组和C组均未发生。A组丙泊酚麻醉诱导时患儿心率、血压出现显著下降(P <0. 05); B组和C组患儿麻醉诱导时血压、心率未见明显变化。A组和B组均出现术后躁动病例,C组未发生术后躁动。A组、B组和C组手术时间比较差异无统计学意义(P> 0. 05),B组和C组手术患儿苏醒时间明显快于A组(P <0. 05)。结论七氟醚吸入麻醉复合局部浸润麻醉能满足患儿舌系带矫正手术要求,且具有较安全、舒适、无躁动、清醒迅速等优点,值得临床推广。

Objective Comparison of the clinical effects of three different anesthetic methods in children with lingual frenulum correction.Methods 90 children with lingual frenulum,aged 1.5~4 years,were randomly divided into 3 groups:Propofol intravenous anesthesia group(group A),sevoflurane inhalation anesthesia group(group B)and sevoflurane inhalation anesthesia combined with local infiltration anesthesia group(group C),30 children in each group.Results There was no significant difference in weight and sex between the three groups(P>0.05).There were 3 cases of body movement in group A,2 cases of body movement in group B,and no occurrence in group C.There was 1 cases of SpO2<95%in group A,group B and group C didn’t happen.In group A,the heart rate and blood pressure decreased significantly during propofol anesthesia induction(P<0.05),in group B and C,there was no significant change in blood pressure and heart rate during anesthesia induction.Postoperative restlessness occurred in group A and group B,and not occurred in group C.There was no statistical difference between the three groups of operation time,recovery time of group B and group C patients was significantly shorter than that of group A(P<0.05).Conclusion Sevoflurane inhalation anesthesia combined with local infiltration anesthesia can safely and steadily meet the requirements of corrective surgery for lingual frenulum in children,no postoperative restlessness occurred,which is worthy of clinical promotion.