CAJ | 학술논문

目的：比较丙泊酚联合七氟醚麻醉与丙泊酚全凭静脉麻醉对小儿腹股沟斜疝术中麻醉药用量、血流动力学、呼吸节律、脑电双频指数（ BIS）及苏醒时间的影响，优选麻醉方法。方法2～6岁行腹股沟斜疝手术患儿40例， ASAⅠ～Ⅱ级，分为联合用药组（丙泊酚联合七氟醚， C组）和丙泊酚组（ P组）。 C组：7％七氟醚吸入诱导，1．5％～2．5％七氟醚和泵注70～100μg· kg﹣1· min﹣1丙泊酚维持麻醉。 P组：丙泊酚2～2．5 mg/kg诱导，泵注丙泊酚100～160μg· kg﹣1· min﹣1维持麻醉。2组持续输注瑞芬太尼0．25μg· kg﹣1· min﹣1镇痛。记录2组诱导前（T0）、诱导后2 min（T1）、插喉罩即刻（T2）、手术切皮（T3）、术中20 min（T4）、手术结束（T5）时的平均动脉压（ MAP）、心率（ HR）、脉搏氧饱和度（ SpO2）、呼吸频率（ RR）、BIS值，术后苏醒时间、麻醉并发症及丙泊酚用量。结果与T0时比较，T1～T5时C组、P组患者MAP、HR、BIS值明显降低（P＜0．05）；与P组比较，T1～T5时C组具有更低的MAP、HR、BIS值和较快的RR（P＜0．05）；T1时P组患者SpO2明显下降（P＜0．05）。术后苏醒时间、麻醉并发症2组间差异无统计学意义；C组丙泊酚用药量较P组减少，差异有统计学意义（P＜0．01）。结论丙泊酚联合七氟醚静吸复合麻醉血流动力学指数、BIS 数值和SpO2更为合理，是一种可用于小儿腹股沟斜疝手术较好的麻醉方法。
목적：비교병박분연합칠불미마취여병박분전빙정맥마취대소인복고구사산술중마취약용량、혈류동역학、호흡절률、뇌전쌍빈지수（ BIS）급소성시간적영향，우선마취방법。방법2～6세행복고구사산수술환인40례， ASAⅠ～Ⅱ급，분위연합용약조（병박분연합칠불미， C조）화병박분조（ P조）。 C조：7％칠불미흡입유도，1．5％～2．5％칠불미화빙주70～100μg· kg﹣1· min﹣1병박분유지마취。 P조：병박분2～2．5 mg/kg유도，빙주병박분100～160μg· kg﹣1· min﹣1유지마취。2조지속수주서분태니0．25μg· kg﹣1· min﹣1진통。기록2조유도전（T0）、유도후2 min（T1）、삽후조즉각（T2）、수술절피（T3）、술중20 min（T4）、수술결속（T5）시적평균동맥압（ MAP）、심솔（ HR）、맥박양포화도（ SpO2）、호흡빈솔（ RR）、BIS치，술후소성시간、마취병발증급병박분용량。결과여T0시비교，T1～T5시C조、P조환자MAP、HR、BIS치명현강저（P＜0．05）；여P조비교，T1～T5시C조구유경저적MAP、HR、BIS치화교쾌적RR（P＜0．05）；T1시P조환자SpO2명현하강（P＜0．05）。술후소성시간、마취병발증2조간차이무통계학의의；C조병박분용약량교P조감소，차이유통계학의의（P＜0．01）。결론병박분연합칠불미정흡복합마취혈류동역학지수、BIS 수치화SpO2경위합리，시일충가용우소인복고구사산수술교호적마취방법。
Objective To compare the effects of inhalation anesthesia with propofol and sevoflurane versus intrave -nous anesthesia with propofol on dosage , hemodynamics, respiratory rhythm, bispectral index (BIS) and resuscitation time during the operation of pediatric oblique inguinal hernia .Methods Forty pediatric patients aged two -to six-year-old in ASA grade I or II with oblique inguinal hernia were randomly divided into two groups ( twenty in each group ) , namely a propofol plus sevoflurane group (group C) and a propofol group (group P).In group C, anesthesia was in-duced by inhalation of 7%sevoflurane, in combination with maintaining dosages of 1.5%to 2.5%sevoflurane and 70-100 μg/kg min propofol (by an injection pump).In Group P, anesthesia was induced by injection of 2-2.5 mg/kg propofol , in combination with maintaining dosages of 100-160 μg/kg min propofol by an injection pump .Patients in both groups were continuously injected with 0.25 μg/kg min for analgesia.Then we recorded the values of mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2), respiratory rate (RR), BIS, resuscitation dura-tion, complication after anesthesia and propofol dosage before induction (T0), after induction (T1), the moment when laryngeal mask insertion started (T2), the moment of incision (T3), 20 minutes after the operation started (T4) , and at the end of operation (T5).Results Compared with T0, the values of MAP, HR, RR and BIS in group P were signif-icantly decreased from T1 to T5 (P<0.05).Compared with group P, group C presents significantly decreased values of MAP, HR and BIS but faster respiratory rates (P<0.05).The level of SpO2 in group P was remarkably lowered at T1 ( P<0.05).No statistical difference was found between both groups in resuscitation duration and complication after anal -gesia.The propofol dosage in group C was significantly less than that in group P (P<0.01).Conclusion Inhalation anesthesia with propofol and sevoflurane presents more rational values of haemodynamics , BIS and SpO2, which is appli-cable for the operation pediatric oblique inguinal hernia with better analgesic effects .