组合式吸入麻醉装置在小儿入手术室前静脉留置针穿刺中的应用研究

Application of combined inhalation anesthesia device in venous indwelling needle puncture in inpatient children before entering into operation room

目的 观察组合式吸入麻醉装置在小儿入手术室前静脉留置针穿刺中的临床效果。方法随机选取2017年11月至2018年3月在本院择期短小手术患儿60例,年龄1~5岁,体质量8~25 kg,按数字表法随机分成组合式吸入麻醉诱导装置组(A组)和肌肉注射氯胺酮组(B组),每组30例。A组采用便携组合式吸入麻醉诱导装置吸入七氟烷2~5 ml;B组采用肌肉注射氯胺酮4~5 ml/kg。观察并记录两组患儿入睡时间、清醒时间、穿刺时体动及醒后复睡的例数。结果 A组患儿入睡时间为(25.27±3.57)s,清醒时间为(28.47±3.87)min,B组分别为(110.93±11.32)s、(57.43±5.26)min,A组入睡时间、清醒时间均较B组明显缩短(均P<0.05);A组醒后复睡0例,B组8例,A组较B组明显减少(P<0.05)。结论 组合式吸入麻醉诱导装置制作简便,易于携带,作为基础麻醉后再行静脉穿刺的麻醉方法,应用于小儿基础麻醉可控性好,患儿及家属易于接受。术毕清醒快,清醒质量好,副作用少,更安全有效,更人性化。

Objective To observe the clinical effect of applying combined inhalation anaesthesia device in the venous indwelling needle puncture in inpatient children before entering into the operation room.Methods Sixty 1-5 year old and 8-25 kg inpatient children taking elective short surgery at our hospital from November,2017 to March,2018 were randomly selected.According to the digital table method,the children were randomly divided into a combined inhalation anaesthesia induction device group(group A)and a ketamine intramuscular injection group(group B),30 cases for each group.Group A used portable combined inhalation anaesthesia induction device to inhale 2 to 5 milliliter sevoflurane;and group B was intramusculally injected ketamine,4 to 5 millilitel per kilogram.The sleeping time,waking time,body movement during puncture and the number of cases of re-sleeping after waking up in the two groups were observed and recorded.Results The sleeping time and waking average time were(25.27±3.57)s and(28.47±3.87)min in group A,and were(110.93±11.32)s and(57.43±5.26)min in group B(both P<0.05).8 cases re-slept after waking up in group B,but none in group A(P<0.05).Conclusions Combined inhalation anaesthesia induction device was simple to make and easy to carry.As an anesthetic method for venipuncture after basic anesthesia,it was applied to inpatient children with good controllin basic anesthesia and is easy to be accepted by inpatient children and their families.After the operation,the children are quicker to wake up,has better waking quality fewer side effects and more humanization,and is more effective and safer.