不同麻醉方案在小儿舌系带矫正术中的临床应用比较  

Comparison of Clinical Application of Different Anesthesia Regimens in Pediatric Frenuloplasty

作　　者：陈昊[1] 徐卉 艾玲 Chen Hao;Xu Hui;Ai Ling(Department of Anaesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉430030

出　　处：《华中科技大学学报（医学版）》2021年第3期358-361,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：2019年心血管多学科整合思维研究基金资助项目。

摘　　要：目的探讨不同麻醉方案在小儿舌系带矫正日间手术中的临床效果及安全性。方法采用回顾性队列研究,纳入同济医院择期行舌系带矫正术的患儿61例。根据不同的麻醉方法将患儿分为3组,七氟烷复合丙泊酚保留自主呼吸组(A组,n=21)、七氟烷复合瑞芬太尼喉罩组(B组,n=20)、七氟烷复合瑞芬太尼气管插管组(C组,n=20),记录3组患儿的手术和苏醒时间,比较患儿术中血氧饱和度低于90%(SpO_(2)<90%)和发生体动的比例,最快心率以及下颌关节松弛度的情况,同时观察患儿苏醒期躁动、恶心呕吐和喉痉挛的情况以及医生操作满意度。结果A组患儿手术时间明显长于B组和C组(均P<0.05),苏醒时间明显短于B组和C组(均P<0.05);A组患儿术中SpO_(2)<90%的发生率明显高于B组和C组(均P<0.05),并且术中体动的发生率高于B组和C组(均P<0.05),平均最快心率高于B组和C组(均P<0.05),下颌关节松弛度良好比例明显低于B组和C组(均P<0.05);3组患儿术后苏醒躁动及恶心呕吐发生率比较差异无统计学意义;C组患儿喉痉挛发生率明显高于A组(P<0.05),B组和C组医生操作满意度明显高于A组。结论对于小儿舌系带矫正日间手术,七氟烷复合瑞芬太尼喉罩全身麻醉是一种安全有效的麻醉方法。Objective To explore the clinical efficacy and safety of different anesthesia regimens in pediatric frenuloplasty.Methods A retrospective cohort study was conducted and 61 children undergoing elective frenuloplasty in our hospital were selected.They were divided into three groups according to different anesthesia schemes:group A(sevoflurane and propofol with spontaneous breathing,n=21);group B(sevoflurane and remifentanil with laryngeal mask airway,n=20);group C(sevoflurane and remifentanil with tracheal intubation,n=20).The operation and recovery time of the children in the three groups were recorded,and the ratio of blood oxygen saturation lower than 90%(SpO_(2)<90%),body movement,the fastest heart rate and mandibular joint laxity during the operation were compared,and the incidence of agitation,nausea,vomiting,laryngospasm during recovery from anesthesia as well as doctor’s satisfaction were observed.Results The operative time of group A was significantly longer than that of group B and group C(P<0.05),and the time of resuscitation was significantly shorter than that of group B and group C(P<0.05).The incidence of SpO_(2)<90%during the operation was significantly higher in group A than in group B and group C(P<0.05).And the incidence of body movement during the operation was significantly higher in group A than in group B and group C(P<0.05).The average of the peak heart rate was significantly higher in group A than in group B and group C(P<0.05).The rate of relaxed mandibular joint during the operation was significantly lower in group A than in group B and group C(P<0.05).There were no statistically significant differences in the incidence of postoperative agitation,nausea and vomiting among the three groups.Additionally,the incidence of laryngospasm was significantly higher in group C than in group A(P<0.05),and the satisfaction of doctors was significantly higher in group B and group C than in group A(P<0.05).Conclusion Combination of sevoflurane and remifentanil with laryngeal mask airway is a safe and e

关 键 词：舌系带过短 舌系带矫正术 麻醉方案 

分 类 号：R614[医药卫生—麻醉学]