三种麻醉方案用于儿外科手术术后苏醒质量的比较

Comparison of the effects of three anesthetic protocols for postoperative recovery in pediatric surgery

目的观察比较三种麻醉方案、麻醉用药在儿外科手术术后苏醒质量情况。方法选取安徽省淮南市妇幼保健院66例儿外科手术患儿,患儿年龄2d^12岁,体质量3~66kg,择机分氯胺酮(1组)、硬膜外或骶管麻醉(2组)、全凭静脉复合气管插管组(3组),记录术后呼吸抑制情况,术后吸氧脉搏血氧饱和度(SpO2)保持95%~100%所需时间,分泌物量,躁动、清醒时间。结果三组麻醉方案术后苏醒质量比较存在差异,第1组口腔分泌物较多和清醒时间较长,第2组口腔分泌物较少且手术结束基本清醒,第3组术后呼吸抑制多,需较长时间吸氧且躁动较多。结论术前合理选择麻醉方案、麻醉用药可保证患儿术中生命体征平稳,血流动力学稳定,手术顺利完成,减少术后并发症。

Objective:To observe and compare the effect of anaesthesia schemes and anaesthesia drugs after pediatric surgery.Methods:66 children of pediatric surgery in Huainan Maternal and Child Health Care Hospital of Anhui Province were selected.The children were aged from 2 days to 12 years old and weighed 3 to 66kg.They were divided into ketamine(group 1),epidural or sacral anesthesia(group 2)and intravenous combined endotracheal intubation(group 3).Postoperative respiratory inhibition was recorded.After operation,respiratory depression,the time required for SpO2 to remain 95%~100%,the secretion volume,the time of restlessness and wakefulness were recorded.Results:There were differences in recovery quality among the three groups.The first group had more oral secretions and longer awake time,the second group had less oral secretions and the patients were basically awake at the end of operation.The proportion of respiratory depression was high in the third group and it required a longer period of oxygen inhalation and more restlessness.Conclusion:The rational choice of anaesthesia before operation and anaesthesia can ensure the stability of vital signs,stable hemodynamics,successful completion of the operation and the reduction of postoperative complications.