七氟醚应用于小儿扁桃体切除术全麻诱导的临床观察  

The clinical observation of general anesthesia induction with sevoflurane in pediatric patients undergoing adenotonsillectomy

作　　者：王薇[1] 王金[1] 韩伟[1] 麻海春[1] 

机构地区：[1]吉林大学第一医院麻醉科,吉林长春130021

出　　处：《中国妇幼保健》2009年第15期2143-2145,共3页Maternal and Child Health Care of China

摘　　要：目的:比较七氟醚快速吸入诱导麻醉和氯胺酮肌注诱导麻醉在小儿扁桃体切除术全麻诱导中的应用,进一步探讨七氟醚应用于小儿全麻诱导的安全性和可行性。方法:收集3～7岁行扁桃体切除术且合并阻塞性睡眠呼吸暂停综合征的小儿40例,随机分为七氟醚吸入诱导组(S组)和氯胺酮肌注诱导组(K组),观察两组患儿麻醉诱导期间和术中相关并发症的发生率,记录血流动力学变化及麻醉诱导时间、手术时间。结果:七氟醚组麻醉诱导起效迅速安全,患儿的睫毛反射消失时间、疼痛反应消失时间、手术时间与氯胺酮组比较均缩短,分别为(60.0±9.9)s、(75.0±7.9)s、(10.8±1.7)min和(127.3±19.3)s、(152.3±14.8)s、(14.5±3.2)min(P<0.05)。七氟醚组患儿麻醉诱导期间及术中的血流动力学变化平稳,七氟醚组患儿合作程度及家属满意度均明显高于氯胺酮组。两组并发症发生率没有明显差异。结论:七氟醚快速吸入麻醉诱导用于小儿扁桃体切除术的全麻诱导,患儿合作程度高,诱导起效安全迅速;喉痉挛及呼吸抑制发生率低;血流动力学平稳;不增加小儿躁动和非适应性行为的改变,是一种安全、有效的麻醉诱导方法。Objective： To compare the effect of general anesthesia induction with sevoflurane and ketamine, explore the safety and feasibility of sevoflurane in induction of anesthesia of children. Methods ： 40 children aged 3 - 7 years old undergoing adenotonsillectomy complicated with obstructive sleep apnea syndrome were divided into inhalational induction anesthesia with sevoflurane （group S） and intramuscular injection induction anesthesia with ketamiue （group K） . Hemodynamic data and the incidences of related complications were recorded during the anesthesia induction stage and perioperative stage. Data of the procedure time were recorded： the induction time and the surgery time. Results ： The time - loss of eyelash reflex, loss of pain reaction and surgery time of Group S [ （ 60. 0 ± 9. 9） seconds, （75.0 ±7.9） seconds, （10.8 ±1.7）] minutes were shorter than those of Group K [ （127.3 ±19.3） seconds, （152.3 ±14.8） seconds, （ 14. 5 ±3.2） minutes] （P 〈0. 05） . The hemodynamics was stable during induction and perioperative time in Group S. The cooperation of pediatric patients and the satisfaction of the parents were higher in Group S than those in Group K. There was no difference in incidence of complications between two groups. Conclusion： Rapid inhalational induction with sevoflurane for the pediatric patients scheduled with adenotonsillectomy can be accepted by pediatric patient easier, quickly and safely, and the hemodynamics is stable during the perioperation. It provides low incidence of laryngospasm and respiratory - depression, the incidences of agitation and non - adaptive behavior are low, sevoflurane is a safe and effective anesthesia induction method.

关 键 词：七氟醚 全麻 诱导 小儿 

分 类 号：R164.2[医药卫生—公共卫生与预防医学]