七氟烷吸入麻醉与异丙酚静脉麻醉对疝气手术患儿血流动力学、应激反应及麻醉效果的影响

发布时间：2018-04-28 19:42

本文选题：疝气 + 七氟烷　；参考：《中国药房》2017年11期

【摘要】：目的:探讨七氟烷吸入麻醉与异丙酚静脉麻醉对疝气手术患儿血流动力学、应激反应及麻醉效果的影响。方法:选取2011年5月-2015年9月于湖北省第三人民医院接受疝气手术的86例患儿为研究对象,采用随机数字表法分为试验组和对照组,各43例。试验组患儿给予注射用盐酸替罗非班0.4μg/(kg·min),ivgtt,注射用苯磺顺阿曲库铵0.1 mg/kg+枸橼酸芬太尼注射液1.0μg/kg,iv,进行麻醉诱导;吸入用七氟烷2%~3%进行麻醉维持,必要时追加枸橼酸芬太尼注射液0.5μg/kg,iv。对照组患儿给予异丙酚乳状注射液3 mg/kg+注射用苯磺酸阿曲库铵0.1 mg/kg+枸橼酸芬太尼注射液1.0μg/kg,iv,进行麻醉诱导;丙泊酚注射液3 mg/(kg·h)微泵注入进行麻醉维持,必要时追加枸橼酸芬太尼注射液0.5μg/kg,iv。观察两组患儿麻醉起效时间、血流动力学指标[收缩压(SBP)、舒张压(DBP)和心率(HR)]、应激反应指标[去甲肾上腺素(NE)、肾上腺素(E)和肾素(R)]、苏醒情况,并记录不良反应发生情况。结果:试验组患儿麻醉起效时间为(3.82±0.45)min,明显短于对照组的(5.13±0.74)min,差异有统计学意义(P0.05)。麻醉诱导前,两组患儿SBP、DBP、HR和血清NE、E、R水平比较,差异均无统计学意义(P0.05)。切皮即刻、切皮后5 min、切皮后10 min时,两组患儿SBP、DBP、HR水平均明显高于麻醉诱导前,差异均有统计学意义(P0.05);切皮即刻、切皮后5 min时,试验组上述指标明显低于对照组,差异均有统计学意义(P0.05)。切皮即刻时,两组患儿血清NE、E、R水平均较麻醉诱导前明显升高,但试验组明显低于对照组,差异均有统计学意义(P0.05)。试验组患儿术后的睁眼时间、清醒时间、定向力恢复时间均明显短于对照组,苏醒期躁动量化评分明显低于对照组,差异均有统计学意义(P0.05)。试验组患儿不良反应发生率(0)明显低于对照组(11.6%),差异有统计学意义(P0.05)。结论:七氟烷吸入麻醉较异丙酚静脉麻醉对疝气手术患儿的血流动力学指标影响小,有助于缓解应激反应、促进术后苏醒,且安全性较好。
[Abstract]:Objective: to investigate the effects of sevoflurane inhalation anesthesia and propofol intravenous anesthesia on hemodynamics, stress response and anesthetic effect in children with hernia. Methods: 86 children undergoing hernia operation in Hubei third people's Hospital from May 2011 to September 2015 were selected and randomly divided into two groups: experimental group (n = 43) and control group (n = 43). In the experimental group, tirofiban hydrochloride (0.4 渭 g/(kg) was given intravenously, and fentanyl citrate (1.0 渭 g / kg iv) was administered to fentanyl citrate (0.1 渭 g / kg) for injection, sevoflurane (2%) was inhaled to maintain the anesthesia, and fentanyl citrate (0.5 渭 g / kg) was added as necessary. Children in the control group were given propofol emulsion injection for 3 mg/kg and fentanyl citrate injection 1.0 渭 g / kg / kg iv for injection of atracurium benzenesulfonate for 3 mg/kg, and propofol injection for 3 mg/(kg / h for maintenance of anesthesia. Fentanyl citrate injection 0.5 渭 g / kg iv. The onset time of anesthesia, hemodynamic parameters (SBP, DBP, HRH), stress response (NE, E) and renin (R) were observed, and adverse reactions were recorded. Results: the onset time of anesthesia in the test group was 3.82 卤0.45 min, which was significantly shorter than that in the control group (5.13 卤0.74 min, P 0.05). Before anesthesia induction, there was no significant difference between the two groups in the levels of SBP, DBP, HR and serum neutrol (P 0.05). Immediately after skin incision, 5 minutes after skin incision and 10 min after skin incision, the levels of SBPnDBPHR in both groups were significantly higher than those before anesthesia induction, the difference was statistically significant (P 0.05), and the above indexes in the experimental group were significantly lower than those in the control group immediately after skin incision and 5 min after skin incision. The difference was statistically significant (P 0.05). Immediately after skin incision, the serum NEP level in both groups was significantly higher than that before anesthesia induction, but the level in the experimental group was significantly lower than that in the control group, and the difference was statistically significant (P 0.05). The time of opening eyes, waking time and recovery time of orientation in the test group were significantly shorter than those in the control group, and the score of restlessness in the recovery period was significantly lower than that in the control group, and the difference was statistically significant (P 0.05). The incidence of adverse reactions in the test group was significantly lower than that in the control group (P 0.05). Conclusion: sevoflurane inhalation anesthesia has less effect on hemodynamics than propofol intravenous anesthesia, which is helpful to relieve stress reaction and promote postoperative recovery.
【作者单位】：湖北省第三人民医院麻醉科;武汉市东西湖区妇幼保健院B超室;
【分类号】：R614

【相似文献】