CAJ | 학술논문

目的：比较七氟醚单独与复合不同浓度芬太尼用于幼儿眼科手术的临床疗效。方法将80例择期拟在全麻下行麦粒肿手术的患儿(年龄24~72个月),随机分为4组,每组20例。七氟醚组( S组)给予生理盐水诱导,七氟醚芬太尼1组给予芬太尼2μg/kg诱导( SF1组),七氟醚芬太尼2组给予芬太尼4μg/kg诱导( SF2组),七氟醚芬太尼3组给予芬太尼6μg/kg诱导( SF3组)。观察并记录患儿诱导前( T0)、插管前( T1)、插管即刻( T2)的心率、血氧饱和度、BIS 值、MAC 值、术后苏醒时间,评价出手术室时、入苏醒室10 min 及离开PACU时的躁动分级( Z1、Z2、Z3),记录在 PACU 停留的时间和恶心呕吐的发生率。结果所有研究对象在PACU均无恶心呕吐的发生,且均在30 min后安全回到病房。治疗前后比较各组心率差异有统计学意义( P<0．05),各组诱导时间和手术时间比较差异无统计学意义(P>0．05)。但苏醒时间比较差异有统计学意义(P<0．05)：S组<SF1组<SF2组。各组入PACU躁动率比较差异有统计学意义(P<0．125),即S组>SF1组>SF2组。 S组和SF1组入PACU 10 min和出PACU的躁动率高于SF2组,差异有统计学意义(P<0．125),S组和SF1组比较差异无统计学意义(P>0．125)。 SF3组共做3例,但3个研究对象的苏醒时间均在20 min以上,在PACU停留时间达1 h,综合考虑,舍弃SF3组。结论与单独使用七氟醚相比,给予芬太尼可以更好地维持循环稳定,并且予患儿4μg/kg芬太尼,可以明显降低术后躁动率。
목적：비교칠불미단독여복합불동농도분태니용우유인안과수술적림상료효。방법장80례택기의재전마하행맥립종수술적환인(년령24~72개월),수궤분위4조,매조20례。칠불미조( S조)급여생리염수유도,칠불미분태니1조급여분태니2μg/kg유도( SF1조),칠불미분태니2조급여분태니4μg/kg유도( SF2조),칠불미분태니3조급여분태니6μg/kg유도( SF3조)。관찰병기록환인유도전( T0)、삽관전( T1)、삽관즉각( T2)적심솔、혈양포화도、BIS 치、MAC 치、술후소성시간,평개출수술실시、입소성실10 min 급리개PACU시적조동분급( Z1、Z2、Z3),기록재 PACU 정류적시간화악심구토적발생솔。결과소유연구대상재PACU균무악심구토적발생,차균재30 min후안전회도병방。치료전후비교각조심솔차이유통계학의의( P<0．05),각조유도시간화수술시간비교차이무통계학의의(P>0．05)。단소성시간비교차이유통계학의의(P<0．05)：S조<SF1조<SF2조。각조입PACU조동솔비교차이유통계학의의(P<0．125),즉S조>SF1조>SF2조。 S조화SF1조입PACU 10 min화출PACU적조동솔고우SF2조,차이유통계학의의(P<0．125),S조화SF1조비교차이무통계학의의(P>0．125)。 SF3조공주3례,단3개연구대상적소성시간균재20 min이상,재PACU정류시간체1 h,종합고필,사기SF3조。결론여단독사용칠불미상비,급여분태니가이경호지유지순배은정,병차여환인4μg/kg분태니,가이명현강저술후조동솔。
Objective To compare the effect of sevoflurane combined with fentanyl on children with operation of ophthalmology. Methods Eighty children (24~72 months) undergoing sty surgery were randomly divided into 4 groups. Patients in group S,group SF1,group SF2 and group SF3 were given induction anesthesia of physiological sa-line 5 mL,fentanyl 2 μg/kg,fentanyl 4 μg/kg and fentanyl 6 μg/kg. The heart rate was recorded before induction (T0),before intubation (T1) and at the time point of intubation (T2). The SpO2,BIS value,MAC value and postoper-ative recovery time were assessed. The agitation degree at the time points of waking up ( Z1 ) ,10 min after entering PACU (Z2) and leaving PACU (Z3) was recorded. The residence time in PACU and the incidence of nausea/vomi-ting were assessed. Results No nausea, vomiting reaction case occurred, the patients all returned to the ward after 30 min. There was significant difference in heart rate before and after operation ( P<0. 05 ) . No significant difference was observed in induction time and operation time ( P>0. 05 ) among the groups. There was significant difference in the recovery time (group S<group SF1<group SF2,P<0. 05) and agitation rate (group S>group SF1>group SF2, P<0. 05). The Z2 and Z3 in group S and group SF1 were higher than those of group SF2 (P<0. 125),while there was no significant difference between group S and group SF1 (P>0. 125). There were three subjects in group SF3, however,the recovery time was over 20 min and the residence time was more than 1 h in PACU,therefore,the group was abandoned. Conclusion Compared with sevoflurane alone,sevoflurane combined with fentanyl can maintain a sta-ble circulation,4 μg/kg fentanyl can effectively reduce the incidence of emergence agitation.