摘要
目的分析七氟醚复合丙泊酚及芬太尼在小儿扁桃体摘除手术麻醉中的应用效果。方法选择2013年7月1日—2015年3月31日行小儿扁桃体摘除手术患儿40例为观察对象,采用随机数字表法将患者分为对照组20例和观察组20例,观察组患儿给予七氟醚复合丙泊酚及芬太尼,对照组患儿给予肌注氯胺酮联合丙泊酚以及芬太尼。对麻醉诱导完成时间,诱导时的顺从性评分,术中平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2)、呼吸频率(RR)指标的变化,术后分泌物情况,术毕清醒及拔管时间,以及苏醒期的躁动情况等指标进行观察。结果插管时和拔管后,观察组MAP、HR、RR均低于对照组(P<0.05),但2组SPO2各个时段差异无统计学意义(P>0.05)。观察组患儿顺应性评分为(5.3±0.2)分,显著优于对照组的(7.2±0.7)分;观察组患儿麻醉诱导完成时间为(165.2±10.2)s,显著小于对照组的(233.2±12.6)s,差异具有统计学意义(P均<0.05)。停止麻醉药后,观察组患儿自主呼吸恢复时间、意识恢复时间、气管导管拔出时间均较对照组患儿显著缩短(P均<0.05)。患儿苏醒期过程中,观察组患儿有1例出现躁动,1例出现恶心呕吐,无误吸血液和分泌物,不良反应发生率为10.0%;对照组患儿有5例出现躁动,6例出现恶心呕吐,无误吸血液和分泌物,不良反应发生率为55.0%,2组差异具有统计学意义(P<0.05)。结论七氟醚复合丙泊酚及芬太尼应用于小儿扁桃体摘除手术,不仅安全性高、并发症少,并在一定程度上缩短了患儿的苏醒时间。
Objective To analyze the application of sevoflurane, propofol and fentanyl in tonsillectomy of children. Meth- ods Forty ASA children undergoing elective tonsillectomy were selected,and randomly divided into two groups：the con- trol group received ketamine, propofol and fentanyl （n = 20 ）, the observation group received sevoflurane, propofol and fent- artyl（ n = 20 ）. The anesthesia induction completion time ,induced compliance score,intraoperative mean arterial pressure （ MAP）, heart rate （ HR）, pulse oxygen saturation （ SPO2 ）, respiratory frequency （RR） were compared. The time of extu- bation and wake-up, incidence of agitation and incidence of nausea and vomiting were noted after operation. Results Pa- tients exhibited lower MAP, HR, RR during induction of anesthesia in the observation group than in the control group（ P 〈 0.05 ）. The induced compliance score in the observation group was better than in the control group （ P 〈 0.05 ）. The inci- dence of agitation and incidence of nausea and vomiting were lower in the observation group than in the control group （P 〈 0.05）. The spontaneous breathing recovery time, consciousness recovery time, and extubation time of the observation group was lower than the control group（ P 〈 O. 05 ）. Conclusion In tonsillectomy of children, sevoflurane, propofol and fentanyl has high safety,less side effect, and to some extent, shortens the children wake up time.
出处
《中华全科医学》
2016年第1期65-67,共3页
Chinese Journal of General Practice
