经喉罩七氟烷吸入麻醉与单纯氯胺酮静脉麻醉在小儿斜疝手术中安全性比较  

Comparison of the Security Between Sevoflurane Anaesthesia via Laryngeal Mask Airway and Ketamine Anaesthesia in the Pediatric Hernioplasty

作　　者：刘军华 欧阳爱平[2] 王永洪[3] 

机构地区：[1]江铜集团(铅山)医院麻醉科,江西上饶334599 [2]赣州市人民医院麻醉科,江西赣州341000 [3]厦门大学附属中山医院麻醉科,福建厦门361004

出　　处：《赣南医学院学报》2015年第6期907-909,919,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：福建省卫生厅青年科研基金资助项目(2007-1-44)

摘　　要：目的：观察经喉罩七氟烷吸入麻醉在小儿斜疝修补术中的临床效果及其安全性。方法：选择择期斜疝修补术患儿80例,年龄1-7岁,体重9-30 kg,ASAⅠ-Ⅱ级,心、肺、肝、肾功能均无异常,随机分为2组（n=40）：喉罩组：采用吸入8%七氟烷待下颌关节松弛后放置喉罩,术中保留自主呼吸吸入3%-4%七氟烷,间断追加芬太尼,每次10μg维持麻醉;氯胺酮组：采用单纯氯胺酮静脉麻醉,首剂2 mg·kg^-1,间隔10分钟追加一次,1 mg·kg^-1。记录两组麻醉前后、手术开始时、手术15 min、手术结束时、苏醒时各时间点的HR、MAP、RR、SPO2值;记录手术时间、麻醉时间和苏醒时间;记录术中和苏醒期躁动、呼吸暂停、恶心呕吐、返流误吸、喉痉挛、舌后坠几种麻醉并发症发生情况。结果：喉罩组患儿与氯胺酮组相比较术中HR、MAP、RR和SPO2均更加平稳（P〈0.05）;苏醒时间短（P〈0.05）,术中和苏醒期躁动、呼吸暂停、恶心呕吐、返流误吸、喉痉挛和舌后坠几种麻醉并发症发生也少（P〈0.05）。结论：在小儿斜疝修补术中喉罩下七氟烷吸入麻醉与单纯氯胺酮静脉麻醉相比较更加安全可靠,临床效果更佳。Objective： To compare the security between the sevoilurane anaesthesia via laryngeal mask airway （LMA） and ketamine anaesthesia in the pediatric hernioplasty. Methods： Eighty children（ aged 1 -7, weight 9 - 30 kg） scheduled for hernioplasty were randomized to be two groups （ n = 40 ）. LMA group ： putting laryngeal mask airway after articulationes mandibularis relaxation for inhalation 8% sevoflurane and inhalation 3% - 4% sevoflurane during the surgery, intravenous injection fentanyl 10 μg discontinuous. Ketamine group： adopting ketamine anaesthesia, first 2 mg·kg^-1, 1 mg·kg^-1 ketamine intravenous injection every 10 min. HR, MAP, RR and SPO2 were measured before and after anesthesia, at the beginning of the surgery, 15 min of surgery, end of surgery and during vivification. Surgery time, anaesthesia time and vivification were recorded. At the same time, restlessness, apnea, nausea and vomiting, regurgitation, laryngospasm and glossocoma during surgery and vivification were recorded. Results： There were more balanced in HR, MAP, RR and SPO2 in LMA groups than that in ketamine groups（P 〈 0.05 ）. The awakening time was shorter in LMA group than in ketamine group （P 〈 0.05）. Adverse events such as restlessness, apnea, nausea and vomiting, regurgitation, laryngospasm and glossocoma were fewer in LMA group（P 〈 0.05 ）. Conclusion： Inhaling sevoflurane anaesthesia via LMA is safer than ketamine anaesthesia in the pediatric hernioplasty.

关 键 词：喉罩 七氟醚 氯胺酮 麻醉 疝气 儿童 

分 类 号：R614[医药卫生—麻醉学]