中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
6期
33-35
,共3页
七氟醚%异丙酚%静吸复合麻醉%眼科手术
七氟醚%異丙酚%靜吸複閤痳醉%眼科手術
칠불미%이병분%정흡복합마취%안과수술
Sevoflurane%Propofol%Intravenous-inhalation anesthesia%Ophthalmic operation
目的 探讨七氟醚-异丙酚静吸复合麻醉用于婴儿眼科手术的临床效果.方法 择期行眼科手术患儿60例,性别不限,年龄3～12个月,随机分为两组,每组30例.Ⅰ组患儿采用静吸复合麻醉,Ⅱ组患儿采用全凭静脉麻醉.Ⅰ组患儿七氟醚4～6%吸入诱导,术中七氟醚吸入浓度调至1.5～2.5%,持续静脉注射异丙酚4 mg/(kg·h)维持麻醉.Ⅱ组患儿肌肉注射氯胺酮6 mg/kg,开放静脉,咪达唑仑0.1 mg/kg、芬太尼2 μg/kg、阿曲库铵0.5 mg/kg诱导后气管插管,术中异丙酚4～6 mg/(kg·h)持续静注维持麻醉.分别于麻醉诱导前(T0)、麻醉诱导后(T1)、气管插管时(T2)、停药时(T3)、气管拔管时(T4)、拔管后10 min(T5),记录心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PET-CO2)的变化,并记录苏醒时间、苏醒延迟发生率、呼吸再抑制发生率、苏醒期躁动发生率.结果 与麻醉诱导前比较,Ⅰ组T1时HR降低(P<0.05);与Ⅱ组比较,Ⅰ组苏醒时间缩短,苏醒延迟发生率、呼吸再抑制发生率、术后躁动发生率均降低(P<0.01).结论 七氟醚复合异丙酚用于眼科手术患儿麻醉可产生良好的麻醉效果,不良反应少,术后苏醒迅速,适合婴儿眼科手术.
目的 探討七氟醚-異丙酚靜吸複閤痳醉用于嬰兒眼科手術的臨床效果.方法 擇期行眼科手術患兒60例,性彆不限,年齡3～12箇月,隨機分為兩組,每組30例.Ⅰ組患兒採用靜吸複閤痳醉,Ⅱ組患兒採用全憑靜脈痳醉.Ⅰ組患兒七氟醚4～6%吸入誘導,術中七氟醚吸入濃度調至1.5～2.5%,持續靜脈註射異丙酚4 mg/(kg·h)維持痳醉.Ⅱ組患兒肌肉註射氯胺酮6 mg/kg,開放靜脈,咪達唑崙0.1 mg/kg、芬太尼2 μg/kg、阿麯庫銨0.5 mg/kg誘導後氣管插管,術中異丙酚4～6 mg/(kg·h)持續靜註維持痳醉.分彆于痳醉誘導前(T0)、痳醉誘導後(T1)、氣管插管時(T2)、停藥時(T3)、氣管拔管時(T4)、拔管後10 min(T5),記錄心率(HR)、脈搏血氧飽和度(SpO2)、呼氣末二氧化碳分壓(PET-CO2)的變化,併記錄囌醒時間、囌醒延遲髮生率、呼吸再抑製髮生率、囌醒期躁動髮生率.結果 與痳醉誘導前比較,Ⅰ組T1時HR降低(P<0.05);與Ⅱ組比較,Ⅰ組囌醒時間縮短,囌醒延遲髮生率、呼吸再抑製髮生率、術後躁動髮生率均降低(P<0.01).結論 七氟醚複閤異丙酚用于眼科手術患兒痳醉可產生良好的痳醉效果,不良反應少,術後囌醒迅速,適閤嬰兒眼科手術.
목적 탐토칠불미-이병분정흡복합마취용우영인안과수술적림상효과.방법 택기행안과수술환인60례,성별불한,년령3～12개월,수궤분위량조,매조30례.Ⅰ조환인채용정흡복합마취,Ⅱ조환인채용전빙정맥마취.Ⅰ조환인칠불미4～6%흡입유도,술중칠불미흡입농도조지1.5～2.5%,지속정맥주사이병분4 mg/(kg·h)유지마취.Ⅱ조환인기육주사록알동6 mg/kg,개방정맥,미체서륜0.1 mg/kg、분태니2 μg/kg、아곡고안0.5 mg/kg유도후기관삽관,술중이병분4～6 mg/(kg·h)지속정주유지마취.분별우마취유도전(T0)、마취유도후(T1)、기관삽관시(T2)、정약시(T3)、기관발관시(T4)、발관후10 min(T5),기록심솔(HR)、맥박혈양포화도(SpO2)、호기말이양화탄분압(PET-CO2)적변화,병기록소성시간、소성연지발생솔、호흡재억제발생솔、소성기조동발생솔.결과 여마취유도전비교,Ⅰ조T1시HR강저(P<0.05);여Ⅱ조비교,Ⅰ조소성시간축단,소성연지발생솔、호흡재억제발생솔、술후조동발생솔균강저(P<0.01).결론 칠불미복합이병분용우안과수술환인마취가산생량호적마취효과,불량반응소,술후소성신속,괄합영인안과수술.
Objective To observe the clinical effect of Intravenous-inhalation anesthesia using Sevoflu-rane combined with Propofol in infant undergoing ophthalmic operation. Methods 60 ASA Ⅰ～Ⅱ children aged from 3 to 11 months were selected and randomly divided into two groups: intravenous combined with inhalation anesthesia group (Ⅰ group) (n=30) and total intravenous anesthesia group (Ⅱ group) (n=30). Children in Ⅰ group were induced with sevoflurane(4～6%) and maintained with sevoflurane(1.5～2.5%) and propofol 4 mg/(kg·h) during surgery,while those in Ⅱ group were induced with midazolam 0.1 mg/kg,fentanyl 2 μg/kg, atracurium 0.5 mg/kg after ketamine 6 mg/kgintramuscular injection, and maintained with total intravenous anesthesia with propofol 4～6 mg/(kg·h) The HR,SpO2 and PETCO2 were measured at different time points and recorded the post operation complications. Results Compared with T1 point, the HR was lower and the difference was significant in Ⅰ group(P<0.05). When compared with Ⅱ group the period of revival was shorter and the rates of post operation complications were much lower in Ⅰ group(P<0.01). Conclusion The anesthe-sia method of Intravenous-inhalation combined with sevoflurane and propofol is an ideal method in infant under-going ophthalmic operation.
