七氟醚不同吸入方法在小儿全身麻醉诱导中的效果观察  

The anaesthesia effect evaluation of different sevoflurane inhalational induction methods in children

作　　者：熊虹飞[1] 王龙[1] 张会娟[1] 吴刚[1] 薛荣亮[1] 

机构地区：[1]西安交通大学第二附属医院麻醉科,710004

出　　处：《国际麻醉学与复苏杂志》2016年第4期306-309,共4页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金（81071070,31300675）

摘　　要：目的对3种七氟醚吸入方法用于小儿全身麻醉诱导的麻醉效果进行对比。方法选择扁桃体、腺样体摘除择期手术患儿90例，ASA分级Ⅰ级，按照随机数字表法分为逐步递增法组（A组）、潮气量法组（B组）、肺活量法组（C组），每组30例。吸入七氟醚160s后行静脉穿刺，之后行进一步全身麻醉诱导。观察3组患儿入亲情诱导室（L）、睫毛反射消失时（T1）、吸入160s后静脉穿刺时（T2）的MAP、HR、SpO2，意识消失时间、穿刺时体动反应发生率，麻醉诱导期间患儿合作程度、有尤体动反应及副作用，手术结束后患儿自主呼吸恢复时间（Tc）、拔管时间（Td），并行躁动评分。结果患儿意识消失时间A组为（58．1±0．3）s，B组为（41．2±0.3）s，C组为（33．8±0．8）s，A组最长而C组最短（P〈0．05）；穿刺时体动反应发生率A组（96．7％）高于B组（16．7％）、C组（13．3％）（P〈0．05）；诱导期体动反应发生率A组（100％）高于B组（13．3％）、C组（10％）（P〈0．05），仅在A组发现患儿发生心动过缓和唾液分泌各1例；诱导期患儿合作程度评分B组（0．20±0．07）分最低，A组（0．77±0．13）分次之，而C组（1．43±0．13）分最高，差异有统计学意义（P〈0．05）。结论在保证血流动力学稳定及不增加副作用发生的前提下，潮气量法吸入8％七氟醚更易为小儿所接受，更加适用于小儿全身麻醉诱导。Objective To evaluate anesthesia effect of three different sevoflurane inhalational induction methods in children. Methods Ninty children patients undergoing elective tonsillectomy or adenoidectomy （ASA I ） were randomly allocated into incremental inhalation group （group A）, fixed-concentration inhalation group （group B） and multiple-deep-breath inhalation group（group C）（n=30）. MAP, HR and SpO2 at the moments of patients entering into the anaesthetic induction room （To）, lose of eyelash telex（%） and intravnous cannulation after 160 s of anaesthetic inhalation （T2） were recorded. Intravenous cannulation was performed if movement and eyelash reflex did not occur after 160 s of anaesthetic inhalation. Induction cooperation, induction time, face mask application to loss of the eyelash reflex, vital signs （MAP, HR, SpO2）, induction complications, recovery time （Tc）, extubation time（Td）, recovery agitation, recovery complications were recorded. Results The time of loss consciousness and eyelash reflex in group A （58.1±0.3） s was the longest but the shortest in group C（33.8±0.8） s （P〈0.05）. Patient movement during eannulation in group A（96.7%） was higher than that in group B（16.7%） and C（13.3%） （P〈0.05）. Patient movement during induction in group A（100%） was higher than that in group B （13.3%） and C （10%） （P〈0.05）. Bradycardia and salivation only happened in one child from group A. Induction compliance checklist in group B（0.20±0.07） was the lowest, whereas the highest in group C（1.43±0.13）（P〈0.05）. Conclusions We recommended the fixed-concentration of sevoflurane （8%） for inhalational induction of anesthesia in chihtren.

关 键 词：七氟醚 小儿全身麻醉 逐步递增法 潮气量法 肺活量法 

分 类 号：R726.1[医药卫生—儿科]