七氟醚复合丙泊酚及芬太尼在小儿扁桃体摘除手术麻醉中的应用  

Application of sevoflurane,propofol and fentanyl in anesthesia for tonsillectomy of Children

作　　者：银含素 李丽霞[1] 陈海林[1] 陈武[1] 何景培[1] 彭丽云[1] 苏薇[1] 利鸿胜[1] 

机构地区：[1]广东省茂名市人民医院麻醉科,广东茂名525000

出　　处：《中国医药科学》2015年第23期135-138,共4页China Medicine And Pharmacy

基　　金：广东省茂名市科技计划项目(2013032)

摘　　要：目的分析七氟醚复合丙泊酚及芬太尼在小儿扁桃体摘除手术麻醉中的应用。方法选择我院2013年7月~2015年3月期间行小儿扁桃体摘除手术患儿40例为观察对象,采用随机数字表法将患者分为对照组20例和实验组20例,实验组患儿给予七氟醚复合丙泊酚及芬太尼,对照组患儿给予肌注氯胺酮联合丙泊酚以及芬太尼。对麻醉诱导完成时间,诱导时的顺从性评分,术中平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SPO2）、呼吸频率（RR）指标的变化,术后分泌物情况,术毕清醒及拔管时间,以及苏醒期的躁动情况等指标进行观察。结果插管时和拔管后,实验组在MAP、HR、RR指标中,均比对照组低,差异有统计学意义（P〈0.05）,但两组在SPO2各个时段无统计学意义（P〉0.05）。实验组患儿顺应性评分为（5.3±0.2）分,显著优于对照组的（7.2±0.7）分;实验组患儿麻醉诱导完成时间为（165.2±10.2）s,显著小于对照组的（233.2±12.6）s,具有统计学意义（P〈0.05）。停止麻醉药后,实验组患儿在自主呼吸恢复时间、意识恢复时间、气管导管拔出时间均较对照组患儿显著缩短,具有统计学意义（P〈0.05）。患儿苏醒期过程中,实验组患儿有1例出现躁动,1例出现恶心呕吐,无误吸血液和分泌物,不良反应发生率为10.0%;对照组患儿有5例出现躁动,6例出现恶心呕吐,无误吸血液和分泌物,不良反应发生率为55.0%,差异具有统计学意义（P〈0.05）。结论七氟醚复合丙泊酚及芬太尼应用于小儿扁桃体摘除手术,不仅安全性高、并发症少,并在一定程度上缩短了患儿的苏醒时间。Objective To analyze the application of sevoflurane,propofol and fentanyl in anesthesia for tonsillectomy of children. Methods 40 children undergoing tonsillectomy in our hospital from July 2013 to March were selected as observational objects and they were randomly divided into the control group and the experimental group according to random number table, with 20 in each. Children in the experimental group were received sevoflurane, propofol and fentanyl while children in the control group were received intramuscular injection of ketamine, propofol and fentanyl. The anesthesia induction completing time, compliance score of induction,intraoperative mean arterial pressure（MAP）,heart rate（HR）,pulse oxygen saturation（SPO2）,change of respiratory rates（RR）,intraoperative secretions,postoperative extubation time and awaking time,irritable conditions and other indexes of two groups were observed. Results MAP,HR and RR during induction and after induction of the experimental group were all lower than those of the control group.The differences had statistical significance（P〈0.05）.SPO2 at various periods of two groups had no significant difference（P〉0.05）.Compliance score of children in the experimental group was（5.3±0.2）,significantly better than that of the control group（7.2±0.7）.The anesthesia induction completing time of children in the experimental group was（165.2±10.2）s,significantly shorter than that of the control group（233.2±12.6）s（P〈0.05）.The differences had statistical significance.After stopped use of anesthetics,The automatic respiratory recovery time,consciousness recovery time and extubation time of children in the experimental group were significantly shorter than those of the control group（P〈0.05）.The differences had statistical significance.In the experimental group,there were 1 case of irritation and 1 case of nausea and vomiting without aspiration of blood and secretions in the awaking period.In cadence of adverse reactions of the experimental g

关 键 词：七氟醚 丙泊酚 芬太尼 扁桃体摘除 小儿 

分 类 号：R726.1[医药卫生—儿科]