七氟醚吸入与丙泊酚全凭静脉麻醉在小儿腭裂修复术中的应用效果比较

Comparison of application effects of Sevoflurane inhalation and Propofol total intravenous anesthesia in children with cleft palate repair

目的:比较七氟醚吸入与丙泊酚全凭静脉麻醉在腭裂修复术患儿中的应用效果。方法:回顾性分析2020年10月至2021年10月该院收治的85例行腭裂修复术患儿的临床资料,按照麻醉方法不同将其分为对照组43例和观察组42例。对照组给予丙泊酚全凭静脉麻醉,观察组给予七氟醚吸入麻醉。比较两组麻醉指标[麻醉诱导时间、苏醒时间、自主呼吸恢复时间、拔管时间、小儿全身麻醉苏醒期躁动量表(PAED)评分]水平、不同时间(术前、术毕)应激指标[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]水平、不同时间[麻醉诱导前(T_(0))、术中30 min(T_(1))、术毕(T_(2))]血流动力学指标(心率、平均动脉压)水平,以及不良反应发生率。结果:观察组麻醉诱导时间、自主呼吸恢复时间、苏醒时间、拔管时间均短于对照组,PAED评分高于对照组,差异有统计学意义(P<0.05);术毕,两组Cor、E、NE水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时,两组心率、平均动脉压水平均高于T_(0)时,但观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:与丙泊酚全凭静脉麻醉比较,七氟醚吸入麻醉应用于小儿腭裂修复术可提高麻醉效果,稳定血流动力学,减轻应激反应,但易导致苏醒期躁动。

Objective:To compare application effects of Sevoflurane inhalation and Propofol total intravenous anesthesia in children with cleft palate repair.Methods:The clinical data of 85 children undergoing cleft palate repair in this hospital from October 2020 to October 2021 were retrospectively analyzed.According to different anesthesia methods,they were divided into control group(43 cases)and observation group(42 cases).The control group was given Propofol total intravenous anesthesia,while the observation group was given Sevoflurane inhalation anesthesia.The levels of anesthesia indexes[anesthesia induction time,recovery time,spontaneous breathing recovery time,extubation time,pediatric anesthesia emergence delirium scale(PAED)score],the stress index levels[cortisol(Cor),epinephrine(E),norepinephrine(NE)]at different time(before the surgery,after the surgery),the hemodynamic index levels(heart rate,mean arterial pressure)at different time[before anesthesia induction(T_(0)),30 min during the surgery(T_(1)),after the surgery(T_(2))],and the incidence of adverse reactions were compared between the two groups.Results:The anesthesia induction time,the spontaneous breathing recovery time,the recovery time and the extubation time of the observation group were shorter than those of the control group,the PAED score was higher than that of the control group,and the differences were statistically significant(P<0.05).At the end of the surgery,the levels of Cor,E and NE in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At T_(1) and T_(2),the levels of heart rate and mean arterial pressure in the two groups were higher than those at T_(0),but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Compared with Propofol total intravenous anesthesia,Sevoflurane inhalation anesthesia can improve the anesthetic effects,stabilize the hemodynamic state and reduce the stress reactions in the children with cleft palate repair,but it is easy to cause restlessness during the recovery period.