七氟醚全凭吸入麻醉在婴儿唇裂整复术中的应用  

The application of total inhalational anesthesia with sevoflurane for cleft lip repair in infants

作　　者：王新河[1] 邵云[1] 李刚[1] 

机构地区：[1]南京大学口腔医学院南京市口腔医院麻醉科,210008

出　　处：《临床麻醉学杂志》2011年第2期160-162,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨七氟醚全凭吸入麻醉在婴儿唇裂整复术中应用的可行性和安全性。方法 60例ASAⅠ级唇裂婴儿随机均分为七氟醚全凭吸入麻醉组(S组)和丙泊酚-芬太尼静脉麻醉组(P组)。记录患儿入室后、气管插管时、手术切皮时、手术开始后30min的HR、MAP;记录拔管时间、改良Aldrete评分达9分所需时间、单位时间维库溴铵用量、苏醒期躁动及术后恶心呕吐情况。结果 P组气管插管时HR明显快于入室后及S组(P<0.01);S组拔管时间和改良Aldrete评分到9分的时间均明显短于P组(P<0.01);S组苏醒期躁动例数多于P组(P<0.05);两组患儿均无苏醒期呕吐;S组患儿的维库溴铵用量显著小于P组(P<0.01)。结论七氟醚全凭吸入麻醉维持平稳,苏醒迅速完全,可安全用于婴儿唇裂整复手术,其不足是苏醒期躁动发生率高。Objective To compare the feasibility and safety between total inhalation anesthesia with sevoflurane 1 and propofol-fentanyl intravenous anesthesia in cleft lip repair in infants. Methods Sixty cleft lip infants with ASA Ⅰ grade were randomly divided into group S （sevoflurane group, n=30） and group P （propofol-fentanyl group, n=30）. MAP and HR before anesthesia induction, during endotrachea intubation and incision, 30 rain after the beginning of operation were recorded respectively. The extubation time, the time when modified Aldrete score reached to 9, the dosage of vecuronium, and the incidence of agitation and vomiting were also recorded. Results HR in group S was more stable than that in group P during tracheal intubation. The extubation time and the time when modified Aldrete score reached to 9 in group S were significantly decreased. （P〈0.01）. The incidence of agitation in group S was higher than that in group P（P〈0. 01）. There was no statistical significance in the incidence of vomiting between the two groups. The dosage of vecuronium in group S was lower than that in group P （P〈0.01）. Conclusion Total inhalational anesthesia with sevoflurane is a steady anesthesia method for infant cleft lip repair with quick recovery but a high incidence of agitation.

关 键 词：七氟醚 全凭吸入麻醉 婴儿 唇裂 

分 类 号：R726.1[医药卫生—儿科]