室上性心动过速射频消融术病儿七氟醚麻醉的效果

Efficacy of sevoflurane anesthesia for radiofrequency catheter ablation of supraventricular tachycardia in children

目的评价室上性心动过速射频消融术病儿七氟醚麻醉的效果。方法回顾2019年2月至2022年8月在安徽省儿童医院因室上性心动过速而在全身麻醉下行射频消融术的77例病儿临床资料。根据全身麻醉维持方式的不同分为:七氟醚组(S组,45例)和丙泊酚组(P组,32例),S组麻醉维持吸入七氟醚2%~3%;P组麻醉维持静脉泵注丙泊酚4~6 mg·kg^(-1)·h^(-1)。分析并比较两组病儿以下资料:一般资料情况(包括年龄、性别以及体质量),室上性心动过速类型,是否存在预激综合征,手术时间、麻醉恢复以及并发症等相关情况;异丙肾上腺素需求情况、手术成功率和复发率以及术后并发症等。结果两组病人一般资料各指标比较差异无统计学意义(均P>0.05);手术时间S组(111.31±32.05)min与P组(123.22±42.21)min相比差异无统计学意义(P=0.163);消融成功率S组95.6%(43/45)与P组93.8%(30/32)相比差异无统计学意义(P=0.725);自主呼吸恢复时间S组(4.42±1.03)min显著低于P组(8.78±1.23)min(P<0.001);麻醉苏醒时间S组(19.37±5.77)min显著低于P组(23.04±8.33)min(P=0.025);S组随访复发1例,P组随访复发2例,两组相比差异无统计学意义(P=0.762);麻醉及手术相关并发症相比两组差异无统计学意义(P>0.05)。结论在儿科射频消融术中,七氟醚麻醉维持下室上性心动过速消融成功率与丙泊酚相似,但麻醉复苏时间明显缩短;故而此类手术推荐七氟醚维持麻醉。

Objective To evaluate the efficacy of sevoflurane anesthesia for radiofrequency catheter ablation of supraventricular tachycardia in children.Methods The clinical data of 77 children with supraventricular tachycardia who underwent radiofrequency catheter ablation under general anesthesia at Anhui Provincial Children's Hospital from February 2019 to August 2022 were retrospectively analyzed.According to the different maintenance methods of general anesthesia,patients were assigned into sevoflurane group(group S,45 cases)and propofol group(group P,32 cases).In group S,2%-3%sevoflurane was inhaled during anesthesia maintenance.In group P,propofol 4-6 mg·kg^(−1)·h^(−1) was pumped intravenously to maintain anesthesia.The following data were analyzed and compared between the two groups:general data,including age,gender,and body mass,type of supraventricular tachycardia,presence of WolffParkinson-White syndrome,operating time,anesthesia recovery and complications were recorded;the requirement of isoproterenol,the success rate and recurrence rate of surgery,and postoperative complications were analyzed.Results There was no significant difference in general data between the two groups(P>0.05).There was no significant difference in operating time between group S and group P[(111.31±32.05)min vs.(123.22±42.21)min;P=0.163].There was no significant difference in ablation success rate between group S and group P[95.6%(43/45)vs.93.8%(30/32);P=0.725].Spontaneous respiration recovery time in group S was significantly lower than that in group P[(4.42±1.03)min vs.(8.78±1.23)min;P<0.001].The recovery time of anesthesia in group S was significantly lower than that in group P[(19.37±5.77)min vs.(23.04±8.33)min;P=0.025].There was 1 case of recurrence in group S and 2 cases in group P during follow-up,and there was no significant difference between the two groups(P=0.762).There was no significant difference in anesthesia and surgical complications between the two groups(P>0.05).Conclusions In pediatric radiofrequency ablation,the success rate of ablation of supraventricular tachycardia under sevoflurane anesthesia is similar to that of propofol,but the recovery time is significantly shortened.Therefore,sevoflurane is recommended to maintain anesthesia for such operations.