医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2013年
16期
344-345
,共2页
学龄前小儿%七氟烷%丙泊酚%骶管阻滞%腹部以下手术
學齡前小兒%七氟烷%丙泊酚%骶管阻滯%腹部以下手術
학령전소인%칠불완%병박분%저관조체%복부이하수술
Young child%Sevoflarane%Propofol%Sacral block%Lower abdominal surgery
目的观察七氟烷复合丙泊酚辅助骶管阻滞应用于学龄前（1~6岁）小儿腹部以下部位择期手术的临床效果。方法选择ASAI~II级、1~6岁患儿80例随机平均分成两组：七氟烷复合丙泊酚辅助骶管阻滞组（S组）及全凭静脉麻醉组（T组），两组患儿入室后常规持续吸氧，监测SPO2，HR，NIBP，R等生命体征，S组先予7%七氟烷面罩吸入使其入睡安静后开通外周静脉通道，再予0.4%罗哌卡因2 mg/Kg行骶管阻滞术，围术期静脉微泵推注丙泊酚4~6 mg/Kg/h维持镇静。 T组予氯胺酮5~10 mg/Kg肌注，患儿入睡安静后常规面罩持续吸氧，开放外周静脉通道予氯胺酮2~5 mg/Kg/h及丙泊酚4~6 mg/Kg/h分别微泵静脉推注。结果围术期患儿生命体征S组较T组更平稳，且S组未出现明显呼吸抑制，术中及术后无躁动、呕吐、及延迟性呼吸抑制等不良反应，麻醉复苏时间较全凭组明显缩短。结论小儿七氟烷复合丙泊酚辅助骶管阻滞麻醉效果满意，围术期安全性高，优于全凭静脉麻醉。
目的觀察七氟烷複閤丙泊酚輔助骶管阻滯應用于學齡前（1~6歲）小兒腹部以下部位擇期手術的臨床效果。方法選擇ASAI~II級、1~6歲患兒80例隨機平均分成兩組：七氟烷複閤丙泊酚輔助骶管阻滯組（S組）及全憑靜脈痳醉組（T組），兩組患兒入室後常規持續吸氧，鑑測SPO2，HR，NIBP，R等生命體徵，S組先予7%七氟烷麵罩吸入使其入睡安靜後開通外週靜脈通道，再予0.4%囉哌卡因2 mg/Kg行骶管阻滯術，圍術期靜脈微泵推註丙泊酚4~6 mg/Kg/h維持鎮靜。 T組予氯胺酮5~10 mg/Kg肌註，患兒入睡安靜後常規麵罩持續吸氧，開放外週靜脈通道予氯胺酮2~5 mg/Kg/h及丙泊酚4~6 mg/Kg/h分彆微泵靜脈推註。結果圍術期患兒生命體徵S組較T組更平穩，且S組未齣現明顯呼吸抑製，術中及術後無躁動、嘔吐、及延遲性呼吸抑製等不良反應，痳醉複囌時間較全憑組明顯縮短。結論小兒七氟烷複閤丙泊酚輔助骶管阻滯痳醉效果滿意，圍術期安全性高，優于全憑靜脈痳醉。
목적관찰칠불완복합병박분보조저관조체응용우학령전（1~6세）소인복부이하부위택기수술적림상효과。방법선택ASAI~II급、1~6세환인80례수궤평균분성량조：칠불완복합병박분보조저관조체조（S조）급전빙정맥마취조（T조），량조환인입실후상규지속흡양，감측SPO2，HR，NIBP，R등생명체정，S조선여7%칠불완면조흡입사기입수안정후개통외주정맥통도，재여0.4%라고잡인2 mg/Kg행저관조체술，위술기정맥미빙추주병박분4~6 mg/Kg/h유지진정。 T조여록알동5~10 mg/Kg기주，환인입수안정후상규면조지속흡양，개방외주정맥통도여록알동2~5 mg/Kg/h급병박분4~6 mg/Kg/h분별미빙정맥추주。결과위술기환인생명체정S조교T조경평은，차S조미출현명현호흡억제，술중급술후무조동、구토、급연지성호흡억제등불량반응，마취복소시간교전빙조명현축단。결론소인칠불완복합병박분보조저관조체마취효과만의，위술기안전성고，우우전빙정맥마취。
Objective to investigate sevoflurane and propofol combined with sacral block selected lower abdominal surgery, clinical ef ect in young child. Methods A total of 80 patients age 0~6 years, ASA I-II patients were randomiged divided two group: receving sevoflurane and propofol combined with sacral block (group S) and total intravenous anesthesia (group T). When two group patients into operation room after, routine continual uptake oxygen monitoring R, HR, NIBP, SPO2 Basic vital signs. Group S first uptake 7%sevoflurane by mask. Then patients into sedate sleep state, and then perivenipunctive veneclysis after with 0.4%ropivacaine 2mg/kg sacral block and preioperation receiving propofol 4~6mg/(kg.h) maitaine sedate state by target control ed infusion. Group T receiving ketamine 5~10mg/kg IM, patients sleep after routine continoul with mask uptake oxygen. Katamine 2~5mg/(kg.h), propofol 4~6mg/(kg.h) respective target control ed infusion. Results Basic vital signs during prioperation young child showed more stabiliged group S comprared with group T. there were not significantly respiratory depression in group S during operation and postoperation absence of emergency agitation and Vometing and prolonged respiratory depression, anesthesia recovery time were to reduce in group S. Conclusion The anesthesia ef ect is bet er that is sevoflarane and propofol combined with sacral block in young child, during prioperation were high safety, group S were excel ent then group T .
