CAJ | 학술논문

目的：探讨阻塞性黄疸因素对患儿七氟醚麻醉恢复的影响。方法择期行Kasai手术的胆道闭锁患儿42例，设为阻塞性黄疸组（ OJ组），非黄疸患儿38例，设为对照组（ C组）。患儿年龄1～4个月，足月儿，体重3．2～8．0 kg。术中吸入2％～4％七氟醚维持麻醉，关腹膜时吸入4％七氟醚至术毕。记录停止吸入七氟醚至BIS值恢复至60、70、80、90的时间。记录停止吸入七氟醚至潮气量恢复至6 ml∕kg、肌力恢复至Ⅲ级、无刺激下自主睁眼和拔除气管导管的时间和相应时点的BIS值。记录入室BIS值、术毕BIS值和麻醉恢复期最高BIS值。记录麻醉苏醒延迟的发生情况。结果与C组比较，OJ组停止吸入七氟醚至无刺激下自主睁眼、拔除气管导管的时间延长，术毕BIS值降低（ P＜0．05），其余指标差异无统计学意义（ P＞0．05）。2组均未发生麻醉苏醒延迟。结论单纯七氟醚吸入麻醉时，阻塞性黄疸患儿虽然麻醉恢复时间延长，但无临床意义。
목적：탐토조새성황달인소대환인칠불미마취회복적영향。방법택기행Kasai수술적담도폐쇄환인42례，설위조새성황달조（ OJ조），비황달환인38례，설위대조조（ C조）。환인년령1～4개월，족월인，체중3．2～8．0 kg。술중흡입2％～4％칠불미유지마취，관복막시흡입4％칠불미지술필。기록정지흡입칠불미지BIS치회복지60、70、80、90적시간。기록정지흡입칠불미지조기량회복지6 ml∕kg、기력회복지Ⅲ급、무자격하자주정안화발제기관도관적시간화상응시점적BIS치。기록입실BIS치、술필BIS치화마취회복기최고BIS치。기록마취소성연지적발생정황。결과여C조비교，OJ조정지흡입칠불미지무자격하자주정안、발제기관도관적시간연장，술필BIS치강저（ P＜0．05），기여지표차이무통계학의의（ P＞0．05）。2조균미발생마취소성연지。결론단순칠불미흡입마취시，조새성황달환인수연마취회복시간연장，단무림상의의。
Objective To evaluate the effect of obstructive jaundice on recovery from sevoflurane anesthesia in pediatric patients. Methods A total of 80 pediatric patients scheduled for elective surgery were included, 42 pediatric patients with biliary atresia scheduled for Kasai operation served as obstructive jaundice group ( group OJ ) , and 38 pediatric patients scheduled for other operations served as control group ( group C) . Pediatric patients were 1-4 months old and full?term infants, and weighed 3.2-8.0 kg. Anesthesia was maintained with inhalation of 2%-4% sevoflurane during surgery, and pediatric patients inhaled 4% sevoflurane staring from peritoneum closure until the end of surgery. The duration from closing sevoflurane vaporizer to BIS value reaching 60, 70, 80 and 90 was recorded. The duration from stop of sevoflurane inhalation to BIS value returning to 60, 70, 80 and 90 was recorded. The duration from termination of sevoflurane inhalation to the time for tidal volume returning to 6 ml∕kg, to the time for muscle strength recovering to grade Ⅲ, to spontaneous eye opening and to tracheal extubation, and the corresponding BIS values were recorded. BIS value while entering the operating room, BIS value at the end of surgery, and the highest BIS value during recovery from anesthesia were recorded. The occurrence of delayed emergence from anesthesia was recorded. Results Compared with group C, the duration from termination of sevoflurane inhalation to spontaneous eye opening and to tracheal extubation were significantly prolonged, and BIS value at the end of surgery was decreased, and no significant change was found in the other parameters in group OJ. No pediatric patients developed delayed emergence from anesthesia in the two groups. Conclusion When only sevoflurane is used for inhalation anesthesia, although the time for recovery from anesthesia is prolonged, it shows no significant difference clinically in pediatric patients with obstructive jaundice.