七氟烷麻醉在兒童扁桃體切除手術中的應用

【摘 要】目的：觀察七氟烷（凱特力）吸入麻醉用于兒童扁桃體切除手術的效果。方法：ASA I～ Ⅱ級、擇期全麻下行扁桃體切除手術的兒童患者80例，隨機分為七氟烷組（A組）和異氟烷組（B組）各40例。A組患者麻醉誘導采用吸入七氟烷+靜脈給藥的方式，術中麻醉維持采用吸入3%的七氟烷，B組患者麻醉誘導采用吸入異氟烷+靜脈給藥的方式，術中麻醉維持采用吸入2%的異氟烷。觀察兩組患者麻醉前2min、氣管插管時、手術開始時及蘇醒時患者的HR、SBP、DBP、SPO2、蘇醒時間以及不良反應發生率。結果：與麻醉前相比，B組患者在氣管插管時、手術開始時以及蘇醒時的HR增快（P<0.05），而SBP、DBP、SPO2在各時間點無明顯差異（P>0.05）；A組患者各時間點的生命體征無顯著差異（P>0.05）。與A組相比，B組患者在氣管插管時、手術開始時以及蘇醒時的HR增快（P<0.05），而兩組患者的SBP、DBP、SPO2在各時間點無明顯差異（P>0.05）。與A組相比，B組患者誘導時咳嗽、屏氣發生率較高，蘇醒時間長（P<0.05）。結論：七氟醚吸入麻醉用于兒童扁桃體切除術時麻醉平穩，不良反應少，蘇醒迅速。

【關鍵詞】 七氟烷；麻醉；兒童；扁桃體切除術

【中圖分類號】 R614 【文獻標識碼】 B

Application of Sevoflurane Anesthesia in Children's Tonsillectomy

Xiang Xuqiang

Guanyun，Jiangsu Province People's Hospital Anesthesiology， Guanyun， Jiangsu， 222200

【Abstract】 Objective： To observe the anesthetic effect of sevoflurane in children’s tonsillectomy.Methods： Eighty children patients with physical status I～II scheduled for an elective tonsillectomy under general anesthesia were enrolled in this study. All patients were randomly divided into two groups，group A （40）and group B （n=40）.Patients in group A received an anesthesia induction with inhalational sevoflurane and intravenous drug injection，then intraoperative matainence with 3% inhalational sevoflurane.In contrast， patients in group B received an anesthesia induction with inhalational isoflurane and intravenous drug injection，then intraoperative matainence with 2% inhalational isoflurane. Heart rate（HR），systolic blood pressure（SBP） ，diastolic blood pressure（DBP），pulse oxygen saturation（SPO2），recovery time and the incidence rate of side effects were recorded for all patients at these time point：2 minutes before induction，tracheal intubation，beginning of surgery and patient recovery.Results： Compared with pre-induction values，HR increased at tracheal intubation，beginning of surgery，and patient recovery for patients in group B（P<0.05），while SBP，DBP and SPO2 was of no difference at any time point for these patients（P>0.05）.The vital signs was of no differance at any time point for patients in group A（P>0.05）.Compared with patients in group A， HR increased at tracheal intubation，beginning of surgery，and patient recovery for patients in group B（P<0.05）， while SBP，DBP and SPO2 was of no difference at any time point between two groups（P>0.05）.The incidence of cough and breath-holding was higher，and recovery time was longer for patients in group B compared with patients in group B.Conclusion： When inhalational sevoflurane anesthesia was used in tossilectomy，the anesthesia process was smooth， and the side effets was little，and patients recover rapidly.

七氟烷是新一代揮發性全麻藥，血/氣分配系數較小，麻醉誘導及蘇醒較快，同時該藥物具有芳香氣味，特別適合于小兒麻醉誘導。扁桃體切除術是兒童常見手術。現將扁桃體切除術時七氟烷麻醉與異氟烷麻醉進行比較，觀察七氟烷麻醉的效果及安全性。

1 材料與方法

1.1 研究對象 選擇2011年6月-2011年12月在我院行扁桃體切除術的兒童患者80例，其中男性43例，女性37例，年齡6-12歲，平均為（8.9±2.9）歲，體重18-41kg，平均為（30±13）kg。……