中国临床医学
中國臨床醫學
중국림상의학
CLINICAL MEDICAL JOURNAL OF CHINA
2014年
3期
326-327
,共2页
郭东东%蒋莅%史昊鸿%周志坚%王炫
郭東東%蔣蒞%史昊鴻%週誌堅%王炫
곽동동%장리%사호홍%주지견%왕현
斜方肌挤压%托下颌%喉罩置入%小儿%七氟醚
斜方肌擠壓%託下頜%喉罩置入%小兒%七氟醚
사방기제압%탁하합%후조치입%소인%칠불미
Trapezius squeeze%Jaw thrust%Laryngeal mask airway%Children%sevoflurane
目的：比较斜方肌挤压试验与托下颌试验在儿童七氟醚麻醉下喉罩置入中的应用。方法：择期行斜疝修补术、睾丸固定术等外科短小手术的患儿80例，年龄4～10岁，美国麻醉师协会（ASA ）麻醉分级 I～II级，将其随机分为斜方肌组和托下颌组，每组40例。80例患儿均采用6 L/min氧气及8％七氟醚吸入诱导麻醉，至睫毛反射消失后，托下颌组每10 s托一次下颌，斜方肌组每10 s挤压一次斜方肌，待患儿无体动反应时置入喉罩。记录并比较两组患儿喉罩置入成功率喉罩置入时间，喉罩置入前后心率、血压，呼气末七氟醚浓度（ETsev）、最低肺泡有效浓度（MAC）及不良反应。结果：斜方肌组喉罩置入成功率（95％，38/40）高于托下颌组（75％，30/40），差异有统计学意义（ P＜0．013）；斜方肌组喉罩置入时间较托下颌组长（ P＝0．000）；斜方肌组不良反应的发生明显少于托下颌组；两组喉罩置入前后心率、血压、ETsev、MAC差异均无统计学意义。结论：斜方肌挤压试验适用于评估儿童喉罩置入的的麻醉深度。
目的：比較斜方肌擠壓試驗與託下頜試驗在兒童七氟醚痳醉下喉罩置入中的應用。方法：擇期行斜疝脩補術、睪汍固定術等外科短小手術的患兒80例，年齡4～10歲，美國痳醉師協會（ASA ）痳醉分級 I～II級，將其隨機分為斜方肌組和託下頜組，每組40例。80例患兒均採用6 L/min氧氣及8％七氟醚吸入誘導痳醉，至睫毛反射消失後，託下頜組每10 s託一次下頜，斜方肌組每10 s擠壓一次斜方肌，待患兒無體動反應時置入喉罩。記錄併比較兩組患兒喉罩置入成功率喉罩置入時間，喉罩置入前後心率、血壓，呼氣末七氟醚濃度（ETsev）、最低肺泡有效濃度（MAC）及不良反應。結果：斜方肌組喉罩置入成功率（95％，38/40）高于託下頜組（75％，30/40），差異有統計學意義（ P＜0．013）；斜方肌組喉罩置入時間較託下頜組長（ P＝0．000）；斜方肌組不良反應的髮生明顯少于託下頜組；兩組喉罩置入前後心率、血壓、ETsev、MAC差異均無統計學意義。結論：斜方肌擠壓試驗適用于評估兒童喉罩置入的的痳醉深度。
목적：비교사방기제압시험여탁하합시험재인동칠불미마취하후조치입중적응용。방법：택기행사산수보술、고환고정술등외과단소수술적환인80례，년령4～10세，미국마취사협회（ASA ）마취분급 I～II급，장기수궤분위사방기조화탁하합조，매조40례。80례환인균채용6 L/min양기급8％칠불미흡입유도마취，지첩모반사소실후，탁하합조매10 s탁일차하합，사방기조매10 s제압일차사방기，대환인무체동반응시치입후조。기록병비교량조환인후조치입성공솔후조치입시간，후조치입전후심솔、혈압，호기말칠불미농도（ETsev）、최저폐포유효농도（MAC）급불량반응。결과：사방기조후조치입성공솔（95％，38/40）고우탁하합조（75％，30/40），차이유통계학의의（ P＜0．013）；사방기조후조치입시간교탁하합조장（ P＝0．000）；사방기조불량반응적발생명현소우탁하합조；량조후조치입전후심솔、혈압、ETsev、MAC차이균무통계학의의。결론：사방기제압시험괄용우평고인동후조치입적적마취심도。
Objective:To compare the Application of the trapezius squeeze and jaw thrust in laryngeal mask airway (LMA) in-sertion in children under sevoflurane anesthesia .Methods:A total of 80 children aged 4 to 10 ,American Society of Anesthesiol-ogists(ASA) I-II and undergoing minor operation such as indirect hernia repair and orchiopexy were enrolled and randomly de-vived into trapezius squeezing group(Group T ,n= 40) and jaw thrusting group (Group J ,n= 40) .Anesthisia was induced with 6 L/min oxygen and 8% sevoflurane .When the chileren’s eyelash reflex lose ,jaw thrust/trapezius squeeze was applied every 10 s .The LMA was inserted immediately after the response of childern to trapezius squeeze or jaw thrust disppeared .The successful rates of LMA insertion ,LAM insertion time ,and blood pressure(BP) and heart rate(HR) before and after LMA in-sertion ,end-tidal sevoflurane concentrations (ETsev) ,minimum alveolar concentrations (MAC) in two groups were Recorded and compared .Results:The successful rate of the LMA insertion in Group T (95% ,38/40) was significantly higher than that in the Group J (75% ,30/40) ,there was statistical difference(P= 0 .013);The LMA insertion time in Group T was longer than that in Group J (P=0 .000);the untoward effects in Group T were less than those in Group J ;The BP ,HR ,ETsev ,MAC in two groups had not statistical differences .Conclusions :The trapezius squeeze is more sutable than jaw thrust for assessment of anaesthetic depth in LM A insertion in chilren under sevoflurane anesthesia .
