婴儿手术麻醉用药的选择研究  

Study on anethethetics for infant operation

作　　者：上官明化[1] 魏秀吾[1] 谢爱军[1] 范双炽[1] 钟进财[1] 

机构地区：[1]福建省三明市第二医院麻醉科,福建三明366000

出　　处：《中国当代医药》2011年第27期7-8,39,共3页China Modern Medicine

摘　　要：目的:探讨不同静脉麻醉药加七氟醚吸入麻醉用于婴儿普外、泌尿手术的效果。方法:选择5d～12个月内的婴儿手术90例,随机分为3组,每组30例。静脉用药配方:Ⅰ组,咪唑安定0.1mg/kg、氯胺酮2mg/kg;Ⅱ组,丙泊酚1～1.5mg/kg、氯胺酮2mg/kg;Ⅲ组,咪唑安定0.1mg/kg、芬太尼2～3μg/kg。手术消毒时3组均面罩吸入1%～3%七氟醚,氧流量1.5～2.5L/min维持麻醉,术中根据手术时间、麻醉深浅,患儿生命体征调节七氟醚吸入浓度。观察记录麻醉后5min、结扎疝囊时、手术结束时的HR、MAP、SpO2、RR变化,术毕清醒时间、哭闹、呕吐情况。结果:组内比较,用药后5min、结扎疝囊时与用药前比较,Ⅰ组HR、MAP显著增高(P<0.01);Ⅱ组仅HR增快(P<0.05);Ⅲ组无明显变化。组间比较,Ⅰ组HR、MAP均明显高于Ⅱ、Ⅲ组(P<0.05);呼吸频率Ⅲ组低于Ⅰ、Ⅱ组(P<0.05);SpO23组均保持在96%以上。清醒时间,Ⅱ组为(7.3±3.4)min,Ⅰ、Ⅲ组分别为(10.2±4.6)、(10.7±5.2)min(P<0.01);呕吐,Ⅲ组6例(20%),Ⅰ、Ⅱ组分别为3例(10.0%),2例(6.6%)(P<0.01);哭闹,3组差异无统计学意义(P>0.05)。结论:全凭静脉麻醉辅以七氟醚吸入有协同效应,可明显减少静脉用药量,降低不良反应,术毕清醒迅速、平稳。Objective：To compare the effects of different intravenous anesthetics together with sevoflurane inhalation anesthesia in infants patients undergoing general or urologic surgery.Methods：90 infant patients aged from 5 days to 12 months were randomly divided into three groups,30 cases each.Intravenous anesthetic were given as follows：group I midazolam 0.1 mg/kg,ketamine 2 mg/kg;groupⅡ：propofol 1-1.5 mg/kg,ketamine 2 mg/kg;group Ⅲ,midazolam 0.1 mg/kg,fentanyl 2-3 μg/kg.1%-3% sevofuurane inhalation was used in three groups during the course of disinfection and with a oxygen flow 1.5-2.5 L/min to maintain.The concentration sevoflurane of was adjusted according to the operation lasting time,anesthetic depth and infant patient＇s vital signs.Observed and recorded changes of HR,MAP,SpO2,RR at the time of 5 minutes after anesthesia,hernia sac ligation,and the end of surgery,as well as waking time,crying,vomiting.Results：Compared the effects of sevoflurane inhalationd at the time of 5 imnutes after inhalation and hernia sac ligation with those before sevoflurane inhalationd,in group Ⅰ,HR,MAP increased much（P0.01）,in groupⅡ,only HR increased（P0.05）;no obverous changes in group Ⅲ.And HR,MAP in group Ⅰ were higher than those in groupⅡand Ⅲ（P0.05）.Respiration frequency in group Ⅲ was lower than that in group Ⅰ and Ⅱ（P0.05）.SpO2 kept on a level of 96% or more in three groups.Observed waking time showed that group Ⅱ was（7.3±3.4） min,groupⅠwas（10.2±4.6） min and group Ⅲwas（10.7±5.2） min（P0.01）.Observed the vomiting showed that group Ⅲ was 6 cased（20.0%）,group Ⅰwas 3 cases（10.0%）,and group Ⅱwas 2 cases（6.6%）（P0.01）,there were no significant differences in infants crying（P0.05）.Conclusion：Intravenous anesthesia togethered with sevoflurane inhalation can reduce the amount of intravenous drugs and reduce adverse reactions.

关 键 词：静脉麻醉 婴儿 七氟醚 麻醉 

分 类 号：R614[医药卫生—麻醉学]