七氟烷/氧化亚氮全凭吸入麻醉在小儿手术中的应用  

Sevoflurane/nitrous oxide inhalation anesthesia application during paediatric surgery

作　　者：金泉英[1] 付月珍[1] 王春[1] 姜燕[1] 王则娅[1] 

机构地区：[1]上海交通大学附属儿童医院麻醉科,上海市200040

出　　处：《实用诊断与治疗杂志》2008年第2期102-104,共3页Journal of Practical Diagnosis and Therapy

摘　　要：目的：观察七氟烷用于小儿全凭吸入麻醉的效果。方法：选择ASAⅠ～Ⅱ级、择期手术小儿30例。麻醉诱导采用5%七氟烷、60%氧化亚氮,流量5 L/min（氧气2 L/min、氧化亚氮3 L/min）,观察并记录从吸入麻醉药至睫毛反射消失时间、气管内插管时间,评定插管条件。麻醉维持吸入七氟烷及氧化亚氮,氧气1 L/min、氧化亚氮1 L/min,记录停止吸入麻醉药至患儿有目的的挣扎活动的时间、气管导管拔出的时间、出麻醉复苏室的时间,记录麻醉诱导及苏醒时的不良反应。记录诱导前、气管插管后、切皮时的心率、血压的变化。结果：睫毛反射消失时间（74.80±25.80）s,气管内插管时间（232.25±58.88）s,气管插管条件为优21例,良8例,差1例。停止吸入麻醉药至患儿有目的的挣扎活动的时间（8.83±5.65）min,气管导管拔管的时间（13.19±6.75）min,出麻醉复苏室的时间（18.97±6.27）min。另外诱导前、气管插管后、切皮时的心率变化无统计学意义。气管插管后的血压较诱导前下降,但差异无统计学意义;切皮时的血压进一步下降,与诱导前和气管插管后的血压相比P〈0.01。结论：七氟烷诱导平稳,苏醒快速,血流动力学稳定,不良反应少,是一种理想的小儿吸入麻醉药。Objective To observe the effect of sevoflurane inhalation anesthesia on paediatric surgery. Methods Thirty children with ASA Ⅰ-Ⅱ grade received operation. 5% sevoflurane, 60% nitrous oxide, 5 L/min flow （O2 2 L/min, nitrous oxide 3 L/min）were used for induction of anesthesia. The time of abolition of lash reflex and the time of tracheal intubating were observed and recorded to evaluate the condition of tracheal intubation. Sevoflurane and nitrous oxide, 2 L/min flow （O2 1 L/min, nitrous oxide 1 L/min）were used for maintenance of anesthesia,to record the time of stopping inhalation to purposive action, the time of tracheal catheter extraction, the time of going out post-anesthesia care unit, to record adverse reaction during induction and analepsia of anesthesia, the heart rate and blood pressure at fore induction, post tracheal intubating, and the time of cutting skin. Results The time of abolition of lash reflex was （74. 80 ± 25. 80） seconds, the time of tracheal intubating （232.25± 58.88） seconds, the condition of tracheal intubating was mostly good. The time of stopping inhalation to purposive action was （8.83±5. 65）minutes, the time of tracheal catheter extraction （13. 19± 6. 75）minutes, the time of discharge from post-anesthesia care unit （18. 97±6.27）minutes. The heart rate change had no statistic difference,and the blood pressure descended. Conclusion Sevoflurane is steady for induction, fast for analepsia, stable in haemodynamics, few in adverse reaction, an ideal inhalation anesthesia for children.

关 键 词：全凭吸入麻醉 七氟烷 氧化亚氮 全麻 小儿 

分 类 号：R726.1[医药卫生—儿科]