七氟烷联合阿芬太尼用于儿童扁桃体腺体切除术的临床研究  

Clinical trial of sevoflurane combined with alfentanil in the treatment of tonsillectomy in children

作　　者：吴年生 王辉[1] 张跃东 汪东学 产进中 魏敏[1] WU Nian-sheng;WANG Hui;ZHANG Yue-dong;WANG Dong-xue;CHAN Jin-zhong;WEI Min(Anesthesiology Department,Anqing First People's Hospital Affiliated to Anhui Medical University,Anqing 246003,Anhui Province,China)

机构地区：[1]安徽医科大学附属安庆市第一人民医院麻醉科,安徽安庆246003

出　　处：《中国临床药理学杂志》2023年第22期3253-3256,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察七氟烷联合阿芬太尼治疗用于儿童扁桃体腺体切除术的临床疗效和安全性。方法入选小儿扁桃体腺体肥大的患儿分为对照组和试验组。对照组手术前先给予1~2 mg·kg^(-1)丙泊酚乳状注射液+1 mg·kg^(-1)艾司氯胺酮+0.2 mg·kg^(-1)米库氯铵,插管后给予4~5 mg·kg·h^(-1)的丙泊酚乳状注射液、0.5~1 mg·kg·h^(-1)艾司氯胺酮、0.5 mg·kg·h^(-1)米库氯铵进行维持麻醉;试验组先吸入8%的七氟烷的混合100%氧气,气体流速控制为5 L·min^(-1),患者入睡后再进行静脉诱导,给予1~2 mg·kg^(-1)丙泊酚乳状注射液、20μg·kg^(-1)阿芬太尼、0.2 mg·kg^(-1)米库氯铵,插管后给予2%~3%的七氟烷、0.5~1.0μg·kg·min^(-1)阿芬太尼、4~5 mg·kg·h^(-1)丙泊酚乳状注射液、0.5 mg·kg·h^(-1)米库氯铵维持麻醉。比较2组患者的麻醉相关指标(意识消失、睫毛反射消失、疼痛反应消失及麻醉恢复时间)、血压[收缩压(SBP)、舒张压(DBP)]、心率(HR)、血流动力学[血氧饱和度(SpO_(2))、平均动脉压(MAP)]。结果试验组和对照组分别纳入70例和50例。试验组和对照组在麻醉结束后的血氧饱和度(SpO_(2))分别为(98.49±0.24)%和(94.87±0.46)%;试验组和对照组麻醉后MAP分别为(86.12±7.28)和(83.33±6.98)mmHg;试验组的苏醒、麻醉恢复、疼痛反应消失时间分别为(15.36±7.87)、(125.49±12.35)和(119.92±16.97)min,对照组分别为(20.51±5.43)、(164.05±8.88)和(155.33±24.67)min,试验组上述指标与对照组比较,差异均有统计学意义(均P<0.05)。手术后,试验组的药物不良反应及术后并发症的发生率为18.57%,对照组为48.00%,差异有统计学意义。结论七氟烷联合阿芬太尼的麻醉方式在儿童扁桃体腺体切除术中麻醉效果和安全性较高。Objective To observe the clinical efficacy and safety of sevoflurane combined with afentanil in the treatment of tonsillectomy in children.Methods Children with hypertrophy of tonsil glands were divided into control group and treatment group.Control group was given 1-2 mg·kg^(-1)propofol emulsion injection+1 mg·kg^(-1)esketamine+0.2 mg·kg^(-1)micuronium chloride before operation.After intubation,4-5 mg·kg·h^(-1)propofol emulsion injection,0.5-1 mg·kg·h^(-1)esketamine,and 0.5 mg·kg·h^(-1)micuronium chloride were administered as maintenance anesthesia.The treatment group first inhaled 100%oxygen mixed with 8%sevoflurane,and the gas flow rate was controlled to 5 L·min^(-1).After the patients fell asleep,intravenous induction was performed,and 1-2 mg·kg^(-1)propofol emulsion injection,20μg·kg^(-1)afentanil,0.2 mg·kg^(-1)micuronium chloride were given.After intubation,2%-3%sevoflurane,0.5-1.0μg·kg·min^(-1)afentanil,4-5mg·kg·h^(-1)propofol emulsion injection,and 0.5 mg·kg·h^(-1)micuronium chloride were administered to maintain anesthesia.Anesthesia related indexes(loss of consciousness,loss of eyelash reflex,loss of pain response and recovery time from anesthesia),blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],heart rate(HR),and hemodynamics[blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP)]were compared between the two groups.Results 70 cases were included in the treatment group and 50 cases in the control group.Blood oxygen saturation(SpO_(2))of treatment group and control group after anesthesia were(98.49±0.24)%and(94.87±0.46)%,respectively.The MAP of treatment group and control group after anesthesia was(86.12±7.28)and(83.33±6.98)mm Hg,respectively.The recovery,anesthesia recovery and pain response disappearance time of the treatment group were(15.36±7.87),(125.49±12.35)and(119.92±16.97)min,and the control group were(20.51±5.43),(164.05±8.88)and(155.33±24.67)min,respectively.Compared with control group,the above indexes in treatment group were st

关 键 词：七氟烷 阿芬太尼 艾司氯胺酮 扁桃体腺样体切除 小儿 

分 类 号：R97[医药卫生—药品]