恩纳用于小儿气管异物取出术的临床观察

Observation of EMLA Cream for Tracheal Foreign Body Removal in Children

目的 :小儿气管异物取出术常因小儿不能耐受支气管镜而出现不同程度的屏气和缺氧。本研究目的在于观察恩纳 (EMLACream ,EC)用于小儿气管异物取出术的有效性和安全性 ,以及是否能降低术中小儿屏气和缺氧的发生率及程度。方法 :30名患气管异物的小儿随机分为恩纳组和对照组。恩纳组在支气管镜表面均匀涂抹EC 0 2～ 0 3g。术中记录患儿屏气程度、最低SpO2 的值及追加氯胺酮的例数。术后手术医生对麻醉满意度评分。结果 :恩纳组患儿的屏气程度明显轻于对照组 ,中度以上屏气恩纳组有 4人 (2 6 7% ) ,对照组有 1 1人(73 3% ) (P <0 0 5 )。术中最低SpO2 恩纳组 (93%± 5 % )明显高于对组 (83%± 1 2 % ) ,(P =0 0 1 2 ) ,其中对照组SpO2 最低降至 5 4 % ,而恩纳组最低降至 83%。术中追加氯胺酮的例数恩纳组明显少于对照组 (3人vs1 1人 )(P <0 0 5 )。术后手术医生对麻醉的满意度评分恩纳组 (90 4± 8 8)明显高于对照组 (79 7± 1 3) (P =0 0 2 1 )。结论 :本研究表明 ,EC可安全有效地用于小儿气管异物取出术 ,能明显降低术中小儿屏气和缺氧的发生率及程度 。

Objective:To evaluate the efficacy and safety of EMLA Cream(EC)when applied to tracheal foreign body removal in children whether it can decrease the incidence and degree of breathholding and hypoxia during operation.Methods:Thirty children were randomly assigned to 1 of 2 groups:EC group and control group.A total of 0 2～0 3g of EC was used on the surface of the bronchoscope in EC group.All children received general anesthesia with spontaneous respiration.The degree of breathholding and SpO 2 during operation were recorded.And after operation the surgeon's satisfaction was assessed.Results:The degree of breathholding in EC group was significantly less than in the control group,the lowest SpO 2 in EC group was obviously higher than that of the control group(93±5% vs 83%±12%, P =0 012).The surgeon's satifaction in EC group was higher compared with the control group (90.4±8.8 vs 79 7±13, P =0 021).Conclusion:EC can be used efficiently and safely for tracheal foreign body removal in children,with lower incidence and degree of breathholding and hypoxia during operation and less requirements of additional anesthetics.