七氟醚麻醉与异丙酚复合麻醉在小儿包皮环切术中的应用  

Application of sevoflurane anesthesia and propofol combined anesthesia in circumcision for children

作　　者：肖凌燕[1] 

机构地区：[1]沈阳市第四人民医院麻醉科,110031

出　　处：《中国现代药物应用》2015年第3期3-4,共2页Chinese Journal of Modern Drug Application

摘　　要：目的：比较七氟醚麻醉与异丙酚复合麻醉在小儿包皮环切术中的应用。方法40例行包皮环切术的患儿,随机分为七氟醚组（Ⅰ组）和异丙酚组（Ⅱ组）,各20例。Ⅰ组静脉注射芬太尼3μg/kg,吸入6%七氟醚4 L/min完成诱导插入喉罩,吸入2%~3.5%七氟醚维持麻醉；Ⅱ组静脉注射芬太尼3μg/kg,异丙酚3 mg/kg完成诱导插入喉罩,术中静脉输注异丙酚3~8 mg/（kg·h）复合瑞芬太尼0.1~0.4μg/（kg·min）调节其输注速度维持麻醉。记录两组一次喉罩置入成功率、手术时间、拔管时间、麻醉后恢复室（PACU）停留时间、术后恶心呕吐发生率、PACU期间记录躁动发生情况,采用小儿苏醒期烦躁量表（PAED）评价躁动程度。结果两组手术时间、拔管时间及一次插管成功率比较差异无统计学意义（P〉0.05）；与Ⅰ组相比,Ⅱ组患儿麻醉后恢复室（PACU）停留时间短,躁动发生率低, PAED评分低,术后恶心呕吐发生率低,差异具有统计学意义（P〈0.05）。结论异丙酚复合麻醉对包皮环切术患儿苏醒期效果优于七氟醚复合麻醉,并发症少。Objective To compare the application of sevoflurane anesthesia and propofol combined anesthesia in circumcision for children. Methods A total of 40 children, who underwent circumcision, were randomly divided into sevoflurane group （group Ⅰ） and propofol group （group Ⅱ）, and each group contained 20 cases. Group Ⅰcompleted induced laryngeal mask interposition by 3μg/kg of fentanyl through intravenous injection and 6%sevoflurane through inhalation for 4 L/min, and maintained anesthesia by inhalation of 2%~3.5%sevoflurane. GroupⅡcompleted induced laryngeal mask interposition by 3μg/kg of fentanyl and 3 mg/kg of propofol through intravenous injection, and maintained anesthesia by intravenous injection of 3~8 mg/（kg·h） of propofol combined with 0.1~0.4μg/（kg·min） of remifentanil under adjusted infusion speed. Records were made on success rate of the first laryngeal mask insertion rate, operation time, extubation time, postanesthesia care unit （PACU） stay time, incidences of postoperative nausea and emesis, dysphoria during PACU, and the degree of dysphoria was assessed by pediatric anesthesia emergence delirium （PAED）. Results There was no statistically significant difference of operation time, extubation time, and success rate of the first laryngeal mask insertion between the two groups （P〉0.05）. Compared with the groupⅠ, the groupⅡhad shorter PACU stay time and lower incidence of dysphoria, PAED score, and incidences of postoperative nausea and emesis. The difference had statistical significance （P〈0.05）. Conclusion Propofol combined anesthesia provides better effect in recovery period in circumcision for children than sevoflurane anesthesia, and it contains few complications.

关 键 词：七氟醚麻醉 异丙酚复合麻醉 小儿包皮环切术 

分 类 号：R726.1[医药卫生—儿科]