CAJ | 학술논문

目的：研究舒芬太尼复合七氟醚对婴幼儿单侧 I 度唇裂术后麻醉苏醒质量影响的适宜剂量,探讨此类手术舒芬太尼较佳的给药方案。方法选择 ASA Ⅰ级施行单侧 I 度唇裂手术的婴幼儿81例,随机分为 A、B、C 三组。A 组舒芬太尼0.2μg/kg+顺式苯磺酸阿曲库铵0.15 mg/kg +七氟醚4%全麻诱导,B 组舒芬太尼0.3μg/kg+顺式苯磺酸阿曲库铵0.15 mg/kg+七氟醚4%全麻诱导,C 组舒芬太尼0.4μg/kg+顺式苯磺酸阿曲库铵0.15 mg/kg+七氟醚4%全麻诱导。观察并记录三组患儿在插管前(T1)、插管后(T2)、手术开始时(T3)与气管拔管时(T4)的平均动脉压(MAP)及心率(HR)；记录三组患儿手术时间、呼吸恢复时间、呼之睁眼时间、拔管时间及拔管时 CHW 镇静评分。结果三组患儿 MAP 及 HR 随着舒芬太尼诱导剂量增加而降低,差异有统计学意义(P <0.05)；在 T2时点,患儿 MAP 及 HR 达到高值。A、B 两组呼吸恢复时间、呼之睁眼时间及拔管时间低于 C 组,差异有统计学意义(P <0.05)；三组患儿拔管后 C组 CHW 评分在0~2分有5例,与 A 组、B 组相互比较差异有统计学意义(P <0.05)。结论舒芬太尼用于婴幼儿单侧 I 度唇裂手术时,在七氟醚4%全麻诱导时,随着舒芬太尼剂量从0.2μg/kg 增加到0.4μg/kg,小儿术后麻醉苏醒质量在舒芬太尼0.4μg/kg 时最差,因此建议诱导剂量不应大于0.4μg/kg。
목적：연구서분태니복합칠불미대영유인단측 I 도진렬술후마취소성질량영향적괄의제량,탐토차류수술서분태니교가적급약방안。방법선택 ASA Ⅰ급시행단측 I 도진렬수술적영유인81례,수궤분위 A、B、C 삼조。A 조서분태니0.2μg/kg+순식분광산아곡고안0.15 mg/kg +칠불미4%전마유도,B 조서분태니0.3μg/kg+순식분광산아곡고안0.15 mg/kg+칠불미4%전마유도,C 조서분태니0.4μg/kg+순식분광산아곡고안0.15 mg/kg+칠불미4%전마유도。관찰병기록삼조환인재삽관전(T1)、삽관후(T2)、수술개시시(T3)여기관발관시(T4)적평균동맥압(MAP)급심솔(HR)；기록삼조환인수술시간、호흡회복시간、호지정안시간、발관시간급발관시 CHW 진정평분。결과삼조환인 MAP 급 HR 수착서분태니유도제량증가이강저,차이유통계학의의(P <0.05)；재 T2시점,환인 MAP 급 HR 체도고치。A、B 량조호흡회복시간、호지정안시간급발관시간저우 C 조,차이유통계학의의(P <0.05)；삼조환인발관후 C조 CHW 평분재0~2분유5례,여 A 조、B 조상호비교차이유통계학의의(P <0.05)。결론서분태니용우영유인단측 I 도진렬수술시,재칠불미4%전마유도시,수착서분태니제량종0.2μg/kg 증가도0.4μg/kg,소인술후마취소성질량재서분태니0.4μg/kg 시최차,인차건의유도제량불응대우0.4μg/kg。
Objective To find out the optimum sufentanil administration for infants who underwent the u-nilateral first-degree cleft lip surgery by studying the suitable dose of sufentanil plus sevoflurane resulting in optimum awakening quality from anaesthesia after the above-mentioned surgery. Methods Eighty-one in-fants with grade I ASA underwent the unilateral first-degree cleft lip surgery was randomly allocated into A, B,C groups.Group A was given general anesthesia induction with 0.2 μg/kg sufentanil plus 0.15 mg/kg Cis-Atracurium Besylate plus 4% sevoflurane.Group B was given general anesthesia induction with 0.3 μg/kg sufentanil plus 0.15 mg/kg Cis-Atracurium Besylate and 4% sevoflurane.Group C was given general anes-thesia induction with 0.4 μg/kg sufentanil plus 0.15 mg/kg Cis-Atracurium Besylate plus 4% sevoflurane. Mean arterial pressure (MAP)and heart rate (HR)was observed and recorded before(T1)and after (T2)intu-bation,at the beginning of the operation (T3)and extubation (T4)in three groups.Operation time,breathing recovery time,eye opening time,extubation time and The Children's Hospital of Wisconsin Sedation Scale (CHW)at extubation were all recorded among three groups. Results There was a significant trend that with higher consumption of sufentanil the MAP and HR decreased among the three groups(P<0.05).The chil-dren had the highest MAP and HR at T2.Breathing recovery time,eye opening at request time,extubation time in groups A and B were shorter than group C,the differences was statistically significant (P <0.05 ). There were 5 cases who had CHW score within 0~2 in group C after extubation,comparing with groups A and B,there was statistically significant difference (P <0.05). Conclusion The application of sufentanil com-bined 4% sevoflurane for general anesthesia induction in infants who underwent the unilateral first - degree cleft lip surgery,the recovery quality after anaesthesia was more and more worse with increased dose of sufen-tanil from 0.2 μg/kg to 0.4 μg/kg,the worst awakening quality from post-operative anesthesia occurred at use of 0.4 sufentanil.So,it is suggested that the sufentanil dose should not exceed 0.4 μg/kg for children dur-ing anaesthesia induction.