七氟烷吸入麻醉与异丙酚静脉麻醉在疝气手术患儿麻醉中的应用效果

Effect of Sevoflurane Inhalation Anesthesia and Propofol Intravenous Anesthesia on Anesthesia in Children with Hernia Surgery

目的分析七氟烷吸入麻醉与异丙酚静脉麻醉对疝气手术患儿血流动力学、应激反应及麻醉效果的影响。方法选取2018年3月~2019年6月在我院行疝气手术的70例患儿为研究对象,采用随机数字表法分为对照组和观察组,各35例。对照组采用异丙酚静脉麻醉,观察组采用七氟烷吸入麻醉,比较两组麻醉起效时间、清醒时间、不同时间点[麻醉诱导前(T1)、切皮时(T2)、切皮后5 min(T3)]、血流动力学指标(血压、心率)水平、不同时间点应激反应[甲肾上腺素(NE)、肾上腺素(E)、肾素(R)]以及临床应激反应情况。结果观察组麻醉起效时间、清醒时间均短于对照组,差异有统计学意义(P<0.05);两组T1时间点舒张压(SBP)、收缩压(DBP)、心率比较,差异无统计学意义(P>0.05),观察组T2、T3时间点SBP、DBP、心率均低于对照组,差异有统计学意义(P<0.05);两组T1时间点NE、E和R比较,差异无统计学意义(P>0.05);观察组T2时间点NE、E、R均低于对照组,差异有统计学意义(P<0.05);观察组无不良反应发生,对照组不良反应发生率11.42%,两组比较,差异有统计学意义(P<0.05)。结论七氟烷吸入麻醉在小儿疝气手术中对血流动力学影响小,应激反应轻,临床应用安全性良好,值得临床应用。

Objective To analyze the effects of sevoflurane inhalation anesthesia and propofol intravenous anesthesia on hemodynamics,stress response and anesthesia effect in children with hernia surgery.Methods A total of 70 children who underwent hernia surgery in our hospital from March 2018 to June 2019 were selected as the research subjects,and using the random number table method to divide into control group and observation group,with 35 cases in each group.The control group was intravenously anesthetized with propofol,and the observation group was anesthetized with sevoflurane inhalation anesthesia,comparing the onset time,awake time,and different time points of the two groups[before anesthesia induction(T1),skin incision(T2),after skin incision 5 min(T3)],hemodynamic indicators(blood pressure,heart rate)level,stress response at different time points[norepinephrine(NE),epinephrine(E),renin(R)]and clinical stress response.Results The anesthesia onset time and awake time of the observation group were shorter than that of the control group,the difference was statistically significant(P<0.05);the diastolic blood pressure(SBP),systolic blood pressure(DBP),heart rate at T1 time point between the two groups were not statistically different(P>0.05),SBP,DBP and heart rate of observation group at T2 and T3 time points were lower than that of control group,the difference was statistically significant(P<0.05);There was no statistically significant difference between NE,E and R at the T1 time point between the two groups(P>0.05);the NE,E and R at the T2 time point in the observation group were lower than the control group,the difference was statistically significant(P<0.05);There were no adverse reactions in the observation group and 11.42%in the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion Sevoflurane inhalation anesthesia has little effect on hemodynamics during pediatric hernia surgery,with light stress response and good clinical application safety,which is worthy of clinical application.