七氟醚与丙泊酚用于新生儿麻醉效果的实验研究  

Experiment Research of Propofol and Sevoflurane anesthesia in neonate's operation

作　　者：董愫[1] 金立民[1] 刘嘉[2] 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 [2]吉林大学第一医院甲状腺外科,吉林长春130021

出　　处：《中国实验诊断学》2010年第2期248-251,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省科委基金资助课题(200505226)

摘　　要：目的研究七氟醚和丙泊酚应用于新生儿麻醉的效果。方法60例新生儿随机均分为两组,七氟醚组和丙泊酚组,每组30例。七氟醚组经面罩吸入七氟醚与氧气的混合气体,根据患儿体动反应调节七氟醚的浓度,丙泊酚组静脉注射丙泊酚2.5mg/kg,意识消失后行气管插管。取右侧卧位从骶裂孔注入0.25%罗哌卡因1.0ml/kg。七氟醚组术中持续吸入七氟醚,丙泊酚组静脉持续泵注丙泊酚1.0-1.5mg/(kg.h),保留自主呼吸,间断辅助呼吸维持麻醉。术中连续监测SPO2、HR、BP、RR,记录两组患儿麻醉中意识消失时间、气管插管时间、插管时发生体动、呛咳例数、自主呼吸恢复时间、术中呼吸抑制例数。同时比较患儿术后苏醒时间及质量。结果两组患儿麻醉前SBP、DBP、HR组间比较差异无显著性。诱导期SBP、DBP、HR较麻醉前明显下降(P<0.05)。插管后SBP、DBP、HR较麻醉前明显下降(P<0.05)。丙泊酚组诱导期及插管后SBP、DBP、HR较七氟醚组明显下降(P<0.05)。七氟醚组患儿意识消失时间、气管插管时间均较丙泊酚组明显延长(P<0.05)。七氟醚组患儿恢复自主呼吸时间较丙泊酚组明显缩短(P<0.05)。七氟醚组患儿呼吸抑制发生率较丙泊酚组明显减少(P<0.05)。两组气管插管期间呛咳、体动的发生率无显著性差异(P>0.05)。七氟醚组患儿苏醒时间较丙泊酚组明显缩短(P<0.05)。两组苏醒质量无显著性差异(P>0.05)。结论丙泊酚与七氟醚均可安全有效地应用于新生儿患者。七氟醚更易保证患儿心血管系统及呼吸系统的稳定,值得在新生儿手术中推广应用。Objective To investigate the using of proprfol and sevoflurane in anesthesia in neonate＇ s operation. Methods A total of 60 cases were divided into group propofol and sevoflurane randomly. Each group included 30 neonates. The neonates in group sevoflurane were inhaled the mixture of sevoflurane and oxygen through mask. We regulated the concentration of sevolfurane through the reaction of the neonate （Anesthesia maintained with sevoofurane）. The neonates in group propofol received 2.5 mg/kg propofol by intravenous injection （Anesthesia maintained with propofol 1.0- 1.5 mg/（kg·h））. After sleeping, the tracheal intubation was inserted.Then all of the cases were performed routine caudle anesthesia, selecting 0.25% Ropivocaine, 1 ml/kg. During the operation, SPO2,HR,BP,RR were monitored. The time of sleeping and tracheal intubation, the cases of throat reflection,the recovery and depression time of respiration were all recorded. At the same time, we compared the analepsia of the two groups. Results SBP, DBP, HR were no significant difference at all the time in both groups（ P 〉 0.05）. During the period of inducing and inserting tracheal intubation , SBP, DBP, HR were all declined in both groups, but the group propofol were lower （ P 〈 0.05）. The time of sleeping and inserting tracheal intubation were longer .in group sevoflurane （ P 〈 0. 05 ）. The recovery time of respiration in group sevoflurane were shorter （ P 〈 0.05）. The cases of respiration depression were less in group sevoflurane （ P 〈 0.05）. The cases of throat reflection and the recovery quality of consciousness were no significant difference in both groups （ P 〉 0. 05 ）. But the recovery time in group propofol were longer （ P 〈 0.05）. Conclusion Both sevoflurane and propofol can provide satisfactory anesthesia for the operation of neonate. But anesthesia with sevoflurane maintained more stabilized circulation and respiration.

关 键 词：新生儿 七氟醚 丙泊酚 

分 类 号：R726.1[医药卫生—儿科]