组合式吸入麻醉诱导装置吸入七氟醚复合右美托咪定在包皮环切术中的应用  

Inhaling sevoflurane by combined inhalation anesthesia induction device and dexmedetomidine in pediatric circumcision

作　　者：蒋秋香 曹慧娟 彭晓晗 刘珊珊 Jiang Qiuxiang;Cao Huijuan;Peng Xiaohan;Liu Shanshan(Department of Anesthesiology,Hospital of the 73rd Group Army,Xiamen 361000,China;Department of Anesthesiology,Xiamen Xinkaiyuan Hospital,Xiamen 361000,China)

机构地区：[1]陆军第七十三集团军医院麻醉科,福建厦门361000 [2]厦门新开元医院麻醉科,福建厦门361000

出　　处：《国际医药卫生导报》2021年第11期1636-1640,共5页International Medicine and Health Guidance News

基　　金：厦门市科技计划项目(3502Z20174034)。

摘　　要：目的观察组合式吸入麻醉诱导装置吸入七氟醚复合右美托咪定小剂量泵注在小儿包皮环切术中的应用效果。方法随机数字表法将2019年5月至10月于陆军第七十三集团军医院择期行包皮环切手术的80例患儿分为SD组和K组;SD组40例,年龄(6.04±1.04)岁,K组40例,年龄(6.05±1.06)岁。在麻醉准备间,SD组患儿使用便携式组合吸入装置吸入2 ml七氟醚,K组患儿予肌内注射氯胺酮4.00~5.00 mg/kg,两组患儿入睡后将其推入手术室,立即开放外周静脉,SD组予右美托咪定0.50μg/kg,稀释至20 ml,K组予等量的盐水,两组均10 min泵注完成。术中两组依据体动反应分别追加七氟醚1 ml/次、氯胺酮0.50 mg/kg。记录两组入睡、苏醒、离室时间及心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO_(2));评估苏醒期躁动和改良面部表情评分(FLACC)情况;记录两组围术期生命体征、围术期不良反应。结果SD组入睡、苏醒和离室时间分别为(1.68±0.38)min、(13.08±1.61)min、(27.79±3.33)min,K组分别为(2.70±0.38)min、(25.61±3.12)min、(34.23±4.55)min,SD组入睡、苏醒和离室时间均明显降低(均P<0.05);SD组苏醒期躁动评分为(1.58±0.59)分,K组为(2.53±0.72)分,SD组苏醒期躁动评分明显降低(P<0.05);两组术后FLACC疼痛评分比较,差异无统计学意义(P>0.05)。两组患儿在入室时、苏醒时、离室时HR、MAP、SpO_(2)比较,差异均无统计学意义(均P>0.05);在切皮时和术毕时,SD组的HR、MAP、SpO_(2)分别为(92.93±4.08)次/min、(69.98±3.07)mmHg(1 mmHg=0.133 kPa)、(99.25±0.78)%、(87.28±3.99)次/min、(66.98±2.77)mmHg、(99.18±0.75)%,K组分别为(95.28±3.40)次/min、(71.95±4.49)mmHg、(99.00±0.72)%、(92.48±3.76)次/min、(70.87±3.22)mmHg、(98.93±0.76)%;与K组相比,在切皮时和术毕时,SD组的HR、MAP出现一过性地下降,差异均有统计学意义(均P<0.05),SpO_(2)无明显下降(均P>0.05)。两组患儿无呼吸抑制和恶心呕吐不良反应发生;SD组�Objective To observe the effect inhaling sevoflurane by the combined inhalation anesthesia induction device and pumping a small-dose of dexmedetomidine in pediatric circumcision.Methods Eighty children undergoing selective circumcision at Hospital of the 73rd Group Army from May to October,2019 were divided into an SD group,(6.04±1.04)years old,and a K group,(6.05±1.06)years old,by the rondom number table method with 40 cases in each group.In the anesthesia preparation room,the SD group were inhaled 2 ml sevoflurane by the device,and the K group were intramuscularly injected ketamine 4.00-5.00 mg/kg.After falling asleep,the children in the two groups were pushed into the operation room and their peripheral veins were immediately prepared;the SD group were given dexmedetomidine 0.50μg/kg,which was diluted to 20 ml,and the K group were given the same amount of saline;both groups'drugs were pumped in 10 minutes.In the two groups,sevoflurane 1 ml once and ketamine 0.50 mg/kg were added according to their body movement response.The induction times,recovery times,and departure times,mean artery pressures(MAP),and saturations of pulse oxygen(SpO_(2))in the two groups were recorded.Their agitation and score of Faces,Legs,Activity,Cry,and Consolobility Scale were evaluated during the awake period pain.The perioperative vital signs and adverse reactions in both groups were recorded.Results The induction time,recovery time,and departure time were(1.68±0.38)min,(13.08±1.61)min,(27.79±3.33)min in the SD group,and were(2.70±0.38)min,(25.61±3.12)min,and(34.23±4.55)min in the K group(all P<0.05).The agitation score during the awake period was(1.58±0.59)in the SD group,and was(2.53±0.72)in the K group(P<0.05).There was no significant difference in the pain score of Faces,Legs,Activity,Cry,and Consolobility Scale between the two groups(P>0.05).There were no statistical differences in HR,MAP,and SpO_(2)between the two groups when they entered the operation room,woke up,and left the room(all P>0.05).The HR,MAP,and SpO_(2)

关 键 词：组合式吸入麻醉诱导装置 包皮环切手术 七氟醚 右美托咪定 小儿 

分 类 号：R614[医药卫生—麻醉学]