七氟烷和丙泊酚在儿童口腔日间手术全身麻醉效果的对比性临床研究  

A comparative clinical study of the general anesthesia effects of sevoflurane and propofol in pediatric dental operation

作　　者：严恩石[1,2] 刘莉 余伊[1,2] 吴波[1,2] 尹楠[1,2] 孙强 YAN Enshi;LIU Li;YU Yi;WU Bo;YIN Nan;SUN Qiang(Jiangsu Key Laboratory of Oral Diseases,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,江苏南京210029 [2]南京医科大学附属口腔医院麻醉科,江苏南京210029

出　　处：《口腔医学》2020年第7期630-633,共4页Stomatology

摘　　要：目的探讨分析七氟烷及丙泊酚在儿童口腔日间全麻手术中的应用效果,为寻找安全高效的儿童口腔日间全麻手术药物提供临床依据。方法选择年龄3~6岁,ASAⅠ~Ⅱ级儿童口腔全麻患者40例,随机分为七氟烷组(S组)及丙泊酚组(P组),每组20例。两组均常规静脉诱导麻醉,行气管插管机械通气,S组术中用2%~3%七氟烷维持麻醉,P组用微量泵持续注射注丙泊酚5~8 mg/(kg·h)维持。观察两组患儿诱导麻醉前(T0)、插管后5 min(T1)、手术开始后5 min(T2)、手术结束后(T3)和拔管后5 min(T4)的心率(HR)、脉搏氧饱和度(SpO2)和平均动脉压(MAP)。同时记录拔管时间、呼吸恢复时间和意识恢复时间。记录不良反应(恶心呕吐、术后躁动、呛咳和痉挛)的发生情况。结果S组相较于P组来说,患儿HR及MAP的术前术后波动范围(T4-T0)较小(P<0.001),S组患儿的呼吸恢复时间及拔管时间均显著短于P组(P<0.05),S组相较于P组来说,总体不良反应发生率低,差异具有统计学意义(P=0.038)。结论儿童口腔日间全麻手术中使用七氟烷进行全身麻醉,血流动力学稳定,术后并发症少,推荐在临床上应用此种麻醉方法。Objective To investigate and analyze the clinical application effects of sevoflurane and propofol anesthesia in pediatric dental surgery,to provide the clinical evidence for safe and efficient general anesthetic drugs.Methods Forty pediatric patients aged 3-6 years old were divided into two groups(n=20,each),the sevoflurane group(S)and the propofol group(P).They were rated class Ⅰ to Ⅱ risk by American Society of Anesthesiologists(ASA)criteria.All patients were under regular induced intravenous anesthesia and then endotracheal intubation and mechanical ventilation were conducted.The anesthesia was maintained with 2%-3% sevoflurane inhalation in group S and 5-8 mg/(kg·h)propofol continuous infusion in group P.Heart rate(HR),pulse oxygen saturation(SpO2)and mean artery pressure(MAP)were observed before induced anesthesia(T0),5 minutes after intubation(T1),5 minutes after the start of surgeries(T2),the end of surgeries(T3),and 5 minutes after extubation(T4).The time of extubation,respiratory and conscious recovery,as well as complications(nausea,vomiting,agitation,choking and spasm)during awaking period was also recorded.Results Compared to group P,the fluctuation ranges of HR and MAP before and after operations(T4-T0)were significantly lower in group S(P<0.001).The time of extubation and respiratory recovery in group S was less than that in group P(P<0.05).Also,there was a lower incidence of total side effects in group S and the difference was statistically significant(P=0.038).Conclusion The use of sevoflurane anesthesia in pediatric dental surgery can make hemodynamics stable and cause fewer side effects,which is recommanded in clinical application.

关 键 词：七氟烷 儿童口腔全麻 丙泊酚 

分 类 号：R781.05[医药卫生—口腔医学]