全凭七氟醚吸入麻醉在小儿急性阑尾炎手术中的应用效果及对血流动力学的影响

Effects of sevoflurane inhalation anesthesia in acute appendicitis surgery and its influence on hemodynamics of children

目的探究全凭七氟醚吸入麻醉在小儿急性阑尾炎手术中的应用效果及对血流动力学的影响。方法抽取2018年1月至2019年11月商丘市第四人民医院收治的急性阑尾炎手术患儿70例,按随机数字表法分为对照组和研究组,每组35例。对照组采用丙泊酚静脉麻醉,研究组采用全凭七氟醚吸入麻醉。比较两组患儿的麻醉效果、血流动力学变化及不良反应发生情况。结果研究组睫毛反射及疼痛消失时间、苏醒时间、清醒时间均少于对照组,差异有统计学意义(P<0.05)。两组患儿入室安静后5 min(T1)、麻醉诱导(T2)、切皮时(T3)、手术完成时(T4)的血氧饱和度(SpO2)水平比较,差异未见统计学意义(P>0.05)。T2、T3、T4时,研究组平均动脉压(MAP)、心率(HR)均高于对照组,差异有统计学意义(P<0.05);研究组T2、T3时的MAP、HR高于T1时,对照组T2、T3、T4时的MAP、HR低于T1时,差异有统计学意义(P<0.05)。研究组不良反应发生率(5.71%,2/35)低于对照组(22.86%,8/35),差异有统计学意义(P<0.05)。结论全凭七氟醚吸入麻醉对急性阑尾炎手术患儿麻醉效果较好,对血流动力学影响较小,安全性高。

Objective To investigate the effect of sevoflurane inhalation anesthesia in surgery of acute appendicitis in children and its influence on hemodynamics.Methods Seventy children who underwent acute appendicitis surgery in the Fourth People’s Hospital of Shangqiu from January 2018 to November 2019 were selected, and they were divided into control group and study group by random number table method, with 35 cases in each group. Control group was given propofol intravenous anesthesia, and study group was given sevoflurane inhalation anesthesia. The anesthetic effect, hemodynamics and adverse reactions were compared between the two groups.Results The eyelash reflex time, disappearance time of pain, awakening time and recovery time in study group were shorter than those in control group (P<0.05). There was no statistical difference in the levels of oxygen saturation (SpO2) between the two groups after entering the room and keeping silent for 5 min (T1), at anesthesia induction (T2), at skin incision (T3), and at the completion of surgery (T4), P>0.05. The mean arterial pressure (MAP) and heart rate (HR) in study group were higher than those in control group at T2, T3, T4 (P<0.05);the MAP and HR in study group at T2, T3 were higher than those at T1, and the MAP and HR in control group at T2, T3, T4 were lower than those at T1 (P<0.05). The incidence of adverse reactions in study group (5.71%, 2/35) was lower than that in control group (22.86%, 8/35), P<0.05.Conclusions Sevoflurane inhalation anesthesia in acute appendicitis surgery in children has better anesthetic effects, but has less effect on hemodynamics, with high safety.