不插管全凭吸入七氟醚麻醉在患儿口腔日间手术的应用  

Application of sevoflurane inhalation anesthesia without intubation in day surgery of pediatric dentistry

作　　者：孙强[1] 余伊[1] 刘莉[1] 吴波[1] 严恩石[1] 尹楠[1] SUN Qiang;YU Yi;LIU Li;WU Bo;YAN Enshi;YIN Nan(Department of Anesthesiology,Affiliated Hospital of Stomatology,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室南京医科大学附属口腔医院麻醉科

出　　处：《临床麻醉学杂志》2019年第8期773-775,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察不插管全凭吸入七氟醚麻醉在患儿口腔日间手术应用的效果。方法需行口腔日间手术治疗的患儿84例,男52例,女32例,年龄2~8岁,ASAⅠ级,采用随机数字表法将患儿分为两组,每组42例。七氟醚麻醉组(S组)术中不插管全凭吸入七氟醚麻醉,气管插管静脉全麻组(C组)行常规气管内插管麻醉。记录麻醉诱导时间、麻醉苏醒时间、治疗时间和达到麻醉后出院评分系统(PADSS)12分时间;记录手术结束后15 min、30 min、1 h和2 h的离院标准评分,术中发生体动、呛咳及术后不良反应情况。结果所有患儿全部顺利完成手术,麻醉结束后2 h安全离开医院。S组麻醉诱导、苏醒时间和达到PADSS 12分时间均明显短于C组(P<0.01)。S组麻醉结束后30 min、1 h和2 h的离院标准评分明显高于C组(P<0.05)。无一例患儿术中发生体动或呛咳。但术后C组有13例(31%)患儿发生吞咽不适明显多于S组1例(2%)(P<0.01)。结论与常规气管内插管麻醉比较,不插管全凭吸入七氟醚麻醉更适合用于患儿口腔日间手术。Objective To observe clinical effect of sevoflurane inhalation anesthesia without intubation in day surgery of pediatric dentistry.Methods Eighty-four children undergoing dental ambulatory surgery,52 males and 32 females,aged 2-8 years,ASA physical statusⅠ,were randomly divided into two groups according to the table of random number:either receiving sevoflurane inhalation anesthesia(group S)or endotracheal intubation anesthesia(group C).The durations for anesthesia induction,recovery and treatment were recorded.The time to reach 12 points of PADSS were also recorded.The grades of discharge were recorded immediately at 15 minutes,30 minutes,1 hour and 2 hours after the end of anesthesia.The number of cough and movement were recorded.Results All children underwent successful surgery and were discharged 2 hours after anesthesia.Compared with group C,time of anesthesia induction and recovery were significantly decreased in group S(P<0.01).The time to reach 12 points of PADSS were significantly decreased in group S(P<0.01).The grades of discharge were significantly increased in group S at 15 minutes,30 minutes,1 hour(P<0.05).There were no cough and movement in two groups.There were 13 children(31%)feeling discomfort when swallowing in group C.However,there was only 1(2%)in group S(P<0.01).Conclusion Sevoflurane inhalation anesthesia without intubation reduces the time for induction and recovery as well as hospital stay and has advantages in ambulatory surgery of pediatric dentistry.

关 键 词：七氟醚 气管插管 口腔手术 日间手术 

分 类 号：R61[医药卫生—外科学]