CAJ | 학술논문

目的比较不同麻醉方法对择期行扁桃体切除术患儿术后躁动的影响.方法择期行扁桃体切除术的患儿60例,年龄6～10岁,ASA Ⅰ级,完全随机分为3组,各20例,即静脉泵注丙泊酚加芬太尼并吸入七氟醚维持麻醉组(M组)、单纯吸入七氟醚维持麻醉组(R组)和静脉泵注丙泊酚加芬太尼维持麻醉组(V组).手术结束时停药,观察麻醉时间、术中平均动脉压、HR的变化、术毕苏醒时间,采用躁动评分记录苏醒期的躁动情况.结果 3组的麻醉时间、术中平均动脉压、HR的变化无差异(P＞0.05)；R组比M、V组苏醒时间缩短[(7.5±3.2)min比(11.8±5.6) min、(10.3±4.7)min,P＜0.05],但术后躁动评分明显比M、V组高[(4.1±0.5)分比(3.1±0.5)分、(3.0±0.6)分]且需药物干预例数多[6例(30％)比2例(10％)、2例(10％)](P＜0.01),而M、V组的苏醒时间和术后躁动差异无统计学意义(P＞0.05).结论儿童行扁桃体切除术采用静吸复合麻醉或静脉麻醉维持比单纯吸入麻醉维持的术后躁动发生率低,单纯吸入七氟醚维持麻醉不可取.
목적 비교불동마취방법대택기행편도체절제술환인술후조동적영향.방법 택기행편도체절제술적환인60례,년령6～10세,ASA Ⅰ급,완전수궤분위3조,각20례,즉정맥빙주병박분가분태니병흡입칠불미유지마취조(M조)、단순흡입칠불미유지마취조(R조)화정맥빙주병박분가분태니유지마취조(V조).수술결속시정약,관찰마취시간、술중평균동맥압、HR적변화、술필소성시간,채용조동평분기록소성기적조동정황.결과 3조적마취시간、술중평균동맥압、HR적변화무차이(P＞0.05)；R조비M、V조소성시간축단[(7.5±3.2)min비(11.8±5.6) min、(10.3±4.7)min,P＜0.05],단술후조동평분명현비M、V조고[(4.1±0.5)분비(3.1±0.5)분、(3.0±0.6)분]차수약물간예례수다[6례(30％)비2례(10％)、2례(10％)](P＜0.01),이M、V조적소성시간화술후조동차이무통계학의의(P＞0.05).결론 인동행편도체절제술채용정흡복합마취혹정맥마취유지비단순흡입마취유지적술후조동발생솔저,단순흡입칠불미유지마취불가취.
Objective To compare the postoperative restlessness effect of three anesthesia methods in children with tonsillectomy.Methods Sixty cases of 6-10 years old and American Society of Anesthesiology I grade children with tonsillectomy were divided into three groups( n =20).All of them had tracheal cannula and controlled the respiration with breathing machine after quickly anesthesia induction with lidocaine,fentanyl,vecuronium bromide and propofol.In group M:venous pumped fentanyl combined with propefol and breathe in sevoflurance to keep anesthesia; group R:breathed in sevoflurance to keep anesthesia simple; group V:venous pumped fentanyl combined with propofol to keep anesthesia.Drug discontinuanced afteroperation,and we observed the anesthesia time,intraoperation mean artery pressure( MAP),the change of heart rate and the palinesthesia time afteroperation.We recorded the status with restlessness score in the stage of analepsia.Results The anesthesia time,intraoperation MAP and the change of HR had no difference in three groups ( P ＞ 0.05 ).The palinesthesia time was shorter in group R than that in group M and V[(7.5 ±3.2)min vs( 11.8 ±5.6)min,(10.3 ±4.7)min,P ＜0.05],but the afteroperation restlessness incidence rate was higher in group R than that in group M and V[(4.1 ±0.5) scores vs (3.1 ±0.5)scores,(3.0 ±0.6)scores],and more cases needed drugs to intervention[6 cases(30％ ) vs 2 cases ( 10％ ),2 cases( 10％ )]( P ＜0.0l ).The palinesthesia time and postoperative restlessness had no difference between group M and V.Conclusion The postoperativerestlessness incidence rate is low with intravenous anesthesia or combined with breath in to keep anesthesia of children having tonsillectomy.