中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
z1期
27-28
,共2页
婴幼儿%氯胺酮%七氟烷急诊手术
嬰幼兒%氯胺酮%七氟烷急診手術
영유인%록알동%칠불완급진수술
Infants%ketamine%sevoflurane%emergencye%suegery
目的 探讨婴幼儿急诊手术的麻醉经验.方法 回顾性分析30例急诊手术麻醉患儿的临床资料.按麻醉药物不同分为静吸组和静复组,每组15例.静吸组以七氟烷和氧气混合气体4～6％进行诱导,术中以1.5～2.0％浓度维持；静复组肌肉注射氯胺酮行基础麻醉,给予静脉注射氯胺酮2 ～3 mg/kg进行诱导,术中以氯胺酮0.5 ～1 mg/kg维持；两组患儿均复合丙泊酚、瑞芬太尼、芬太尼、阿曲库铵诱导并维持.观察并记录两组患儿麻醉诱导前(T0)、插管前(T1)、插管即刻(T2)、手术开始(T3)、手术开始10 min (T4)、手术开始20 min(T5)、拔管即刻(T6)、拔管后3 min (T7)的血压(SBP/DBP)、心率(HR)及动脉血氧饱和度(SpO2)；术后记录苏醒时间、拔管时间、出室时间和并发症发生情况.结果 两组患儿麻醉过程中血流动力学稳定,在T1、T2、T3、T4、T5时点血压、心率较T0下降,差异有统计学意义(P＜0.05),T6、T7时点两组化患儿循环系统参数均恢复至T0水平.两组患儿麻醉诱导和维持过程均平稳.术后苏醒时间、拔管时间、出室时间静复组均较静吸组长,差异有统计学意义(P＜0.05)；术后复睡发生率静复组为33.3％,高于静吸组的6.7％,差异有统计学意义(P＜0.05).结论 七氟烷静吸复合麻醉术中能够满足手术要求,苏醒效果好,适合于婴幼儿急诊手术.
目的 探討嬰幼兒急診手術的痳醉經驗.方法 迴顧性分析30例急診手術痳醉患兒的臨床資料.按痳醉藥物不同分為靜吸組和靜複組,每組15例.靜吸組以七氟烷和氧氣混閤氣體4～6％進行誘導,術中以1.5～2.0％濃度維持；靜複組肌肉註射氯胺酮行基礎痳醉,給予靜脈註射氯胺酮2 ～3 mg/kg進行誘導,術中以氯胺酮0.5 ～1 mg/kg維持；兩組患兒均複閤丙泊酚、瑞芬太尼、芬太尼、阿麯庫銨誘導併維持.觀察併記錄兩組患兒痳醉誘導前(T0)、插管前(T1)、插管即刻(T2)、手術開始(T3)、手術開始10 min (T4)、手術開始20 min(T5)、拔管即刻(T6)、拔管後3 min (T7)的血壓(SBP/DBP)、心率(HR)及動脈血氧飽和度(SpO2)；術後記錄囌醒時間、拔管時間、齣室時間和併髮癥髮生情況.結果 兩組患兒痳醉過程中血流動力學穩定,在T1、T2、T3、T4、T5時點血壓、心率較T0下降,差異有統計學意義(P＜0.05),T6、T7時點兩組化患兒循環繫統參數均恢複至T0水平.兩組患兒痳醉誘導和維持過程均平穩.術後囌醒時間、拔管時間、齣室時間靜複組均較靜吸組長,差異有統計學意義(P＜0.05)；術後複睡髮生率靜複組為33.3％,高于靜吸組的6.7％,差異有統計學意義(P＜0.05).結論 七氟烷靜吸複閤痳醉術中能夠滿足手術要求,囌醒效果好,適閤于嬰幼兒急診手術.
목적 탐토영유인급진수술적마취경험.방법 회고성분석30례급진수술마취환인적림상자료.안마취약물불동분위정흡조화정복조,매조15례.정흡조이칠불완화양기혼합기체4～6％진행유도,술중이1.5～2.0％농도유지；정복조기육주사록알동행기출마취,급여정맥주사록알동2 ～3 mg/kg진행유도,술중이록알동0.5 ～1 mg/kg유지；량조환인균복합병박분、서분태니、분태니、아곡고안유도병유지.관찰병기록량조환인마취유도전(T0)、삽관전(T1)、삽관즉각(T2)、수술개시(T3)、수술개시10 min (T4)、수술개시20 min(T5)、발관즉각(T6)、발관후3 min (T7)적혈압(SBP/DBP)、심솔(HR)급동맥혈양포화도(SpO2)；술후기록소성시간、발관시간、출실시간화병발증발생정황.결과 량조환인마취과정중혈류동역학은정,재T1、T2、T3、T4、T5시점혈압、심솔교T0하강,차이유통계학의의(P＜0.05),T6、T7시점량조화환인순배계통삼수균회복지T0수평.량조환인마취유도화유지과정균평은.술후소성시간、발관시간、출실시간정복조균교정흡조장,차이유통계학의의(P＜0.05)；술후복수발생솔정복조위33.3％,고우정흡조적6.7％,차이유통계학의의(P＜0.05).결론 칠불완정흡복합마취술중능구만족수술요구,소성효과호,괄합우영유인급진수술.
Objiects Analysis ofemergencye surgical of infants anesthesia for the operation of such cases sum up the experience of anesthsia.Metheds From 2010 to 2012,30 infants received emergencye surgical in my hospital.According to use of different narcotic drugs,these cases were divided into two groups.Group sevoflurane (group S,n =15),with 4-6％ of sevoflurane mixed air for induction.Group ketamine (group K,n =15),with ketamine 2-3 mg/kg for induction.The both groups were combined with porpofol,remifentanil atracurium bromide.Observed cardiovascular effects,changes and record SBP,DBP,HR before anesthesia,time point before intubate,instantly of intubate,instantly of beginning of surgery,10 min and 20 min after exploration,instantly of extubate and 3 min after extubate.At same time,observed analeptic condition.Results Both groups have same stabilized hemodynamics.The SBP,DBP,HR in two groups decreased at instantly of intubate,instantly of beginning of surgery and 20 min after exploration,and the difference has statistics significance (P ＜ 0.05).Time of wake up in group K is longer than group S,and the difference has statistics significance (P＜ 0.05).After the operation,the rate of sleep of K group (33.3％)are higher than S group (6.7％).Conclusions Comparing with the ketamine,anesthetic induction and maintained with sevoflurane fit for emergencye surgery of infants for the well effectiveness in process of maintenance and wake up.
