地氟烷与七氟烷对接受扁桃体低温等离子消融术治疗患儿麻醉苏醒期的影响

Effect of Desflurane and Sevoflurane on Anesthesia Recovery Period of Children Undergoing Low-Temperature Plasma Ablation of Tonsil

目的观察地氟烷与七氟烷对接受扁桃体低温等离子消融术治疗的患儿麻醉苏醒期的影响。方法使用随机双盲法将2018年8月至2019年12月在商丘市第四人民医院行扁桃体低温等离子消融术治疗的126例患儿分为A、B两组,各63例。A组采用七氟烷麻醉,B组采用地氟烷麻醉。比较两组患儿自主睁眼、拔除气管导管、完全清醒和吞咽功能恢复时间;比较两组在进入麻醉后恢复室(PACU)时、10 min后、30 min后、离开PACU时的儿童麻醉苏醒期躁动评分(PAED);比较两组在进入PACU时、10 min后、30 min后、离开PACU时的CHIPPS疼痛评分;统计两组苏醒期躁动发生率和躁动持续时间;统计两组不良反应发生率。结果B组患儿自主睁眼、拔除气管导管、完全清醒和吞咽功能恢复时间均早于A组(P<0.05);B组进入PACU时、10 min后和30 min后时的PAED评分低于A组(P<0.05);B组进入PACU时和10 min后的CHIPPS评分低于A组(P<0.05);B组躁动发生率低于A组,躁动持续时间短于A组(P<0.05);B组恶心、呕吐不良反应发生率均低于A组(P<0.05)。结论地氟烷麻醉效果优于七氟烷,患儿苏醒速度较快,苏醒质量较高,且患儿不良反应发生率较低,可作为临床首选药物。

Objective To observe the effects of desflurane and sevoflurane on anesthesia recovery period of children undergoing low-temperature plasma tonsil ablation.Methods A total of 126 children receiving low-temperature plasma ablation of tonsils in the Fourth People’s Hospital of Shangqiu from August 2018 to December 2019 were randomly divided into group A(63 cases)and group B(63 cases).Group A was anesthetised with sevoflurane and group B with desflurane.The time of independent eye opening,tracheal catheter removal,full wakening and recovery of swallowing function were compared between the two groups.PAED scores were compared between the two groups when they entered the post-anesthesia recovery room(PACU),10 minutes later,30 minutes later,and when they left PACU.The CHIPPS pain scores of the two groups were compared at PACU entry,10 minutes after,30 minutes after,and leaving PACU.The incidence of restlessness and duration of restlessness in the awakening period of the two groups were analyzed.The incidence of adverse reactions in the two groups was analyzed.Results The time of independent eye opening,endotracheal catheter removal,full awake time and recovery time of swallowing function in group B were all earlier than those in group A(P<0.05).The PAED scores of group B at entering PACU and 10 and 30 minutes after entering PACU were lower than those of group A(P<0.05).The CHIPPS scores of group B were lower than those of group A after entering PACU and 10 minutes after entering PACU(P<0.05).The incidence and duration of agitation in group B were lower than those in group A(P<0.05).The incidence of nausea,vomiting adverse reactions in group B were lower than those in group A(P<0.05).Conclusion The anesthetic effect of desflurane is better than that of sevoflurane,the recovery rate of children is faster,the recovery quality is higher,and the incidence of adverse reactions in children is lower,so desflurane can be used as the first choice in clinic.