全凭静脉全身麻醉与静脉复合七氟烷吸入全身麻醉在小儿麻醉中的安全性比较  

Comparison of safety between total intravenous general anesthesia and intravenous compound Sevoflurane inhalation general anesthesia in pediatric anesthesia

作　　者：迟庆胜 冯伟 徐志秀 刘美蓉 CHI Qingsheng;FENG Wei;XU Zhixiu;LIU Meirong(Department of Anesthesia,Rizhao Hospital of Traditional Chinese Medicine,Shandong Province,Rizhao276800,China;Department of Gastrointestinal Surgery,Rizhao Hospital of Traditional Chinese Medicine,Shandong Province,Rizhao276800,China;Department of Operating Room,Rizhao Hospital of Traditional Chinese Medicine,Shandong Province,Rizhao276800,China;Department of Ultrasound,Rizhao Hospital of Traditional Chinese Medicine,Shandong Province,Rizhao276800,China)

机构地区：[1]山东省日照市中医医院麻醉科,山东日照276800 [2]山东省日照市中医医院胃肠外科,山东日照276800 [3]山东省日照市中医医院手术室,山东日照276800 [4]山东省日照市中医医院超声三科,山东日照276800

出　　处：《中国当代医药》2024年第26期84-88,共5页China Modern Medicine

摘　　要：目的探讨小儿麻醉中实施全凭静脉全身麻醉与静脉复合七氟烷吸入全身麻醉的效果。方法选取2022年9月至2023年9月日照市中医医院收治的60例手术患儿作为研究对象,采用随机数字表法将其分为对照组和观察组,各30例。对照组患儿采用丙泊酚全凭静脉全身麻醉,观察组患儿采用静脉复合七氟烷吸入全身麻醉。比较两组患儿的血流动力学指标、术后苏醒情况、应激反应指标、谵妄发生情况和不良反应发生情况。结果观察组术中的平均动脉压(MAP)、心率(HR)以及术中、术后20 min的血氧饱和度(SpO_(2))高于对照组,差异有统计学意义(P<0.05)。观察组的拔管时间、定向力恢复时间、苏醒时间短于对照组,插管时间、意识消失时间长于对照组,差异有统计学意义(P<0.05)。观察组术后20 min、气管拔管后的血清去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)高于对照组,差异有统计学意义(P<0.05)。观察组术后3 d的儿科麻醉后苏醒期谵妄(PAED)量表评分低于对照组,差异有统计学意义(P<0.05)。观察组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论小儿麻醉中实施静脉复合七氟烷吸入全身麻醉方式,可更好地稳定术中血流动力学,术后快速苏醒及恢复,且减少术后谵妄的发生,安全性有保障,但丙泊酚全凭静脉麻醉可减轻围手术期的应激反应。Objective To explore the effect of total intravenous general anesthesia and intravenous compound Sevoflurane inhalation general anesthesia in pediatric anesthesia.Methods Sixty surgical children admitted to Rizhao Hospital of Traditional Chinese Medicine from September 2022 to September 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with 30 cases in each group.The children in the control group were given Propofol total intravenous anesthesia,while the children in the observation group were given intravenous Sevoflurane inhalation general anesthesia.Hemodynamic indexes,postoperative recovery,stress response indexes,delirium and incidence of adverse reactions were compared between the two groups.Results The mean arterial pressure(MAP),heart rate(HR)during operation,and blood oxygen saturation(SpO_(2))during and 20 min after operation in the observation group were higher than those in the control group and the differences were statistically significant(P<0.05).The extubation time,orientation recovery time and recovery time of the observation group were shorter than those of the control group,and the intubation time and loss of consciousness were longer than those of the control group,the differences were statistically significant(P<0.05).The serum levels of norepinephrine(NE),epinephrine(E)and cortisol(Cor)in the observation group were higher than those in the control group 20 min after trachea extubation,and the differences were statistically significant(P<0.05).Pediatric anesthesia emergence delirium(PAED)scale score 3 days after surgery in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion The implementation of intravenous combined Sevoflurane inhalation general anesthesia in pediatric anesthesia can b

关 键 词：全凭静脉全身麻醉 静脉复合麻醉 七氟烷吸入 小儿麻醉 

分 类 号：R614[医药卫生—麻醉学]