七氟烷复合丙泊酚用于小儿斜视矫正手术患儿的麻醉效果

发布时间：2018-04-12 13:58

本文选题：小儿斜视矫正手术 + 七氟烷　；参考：《医学综述》2016年16期

【摘要】：目的探讨七氟烷复合丙泊酚用于小儿斜视矫正手术患儿的麻醉效果及其安全性。方法将2007年10月至2015年4月湖北省妇幼保健院收治的82例小儿斜视矫正手术患儿按照随机数字表法分为观察组和对照组,各41例。观察组微量泵持续静脉输注3%~5%七氟烷复合6~10 mg/(kg·h)丙泊酚麻醉维持;对照组微量泵持续静脉输注氯胺酮2.5~8.0 mg/(kg·h)维持麻醉。对比分析两组脉搏血氧饱和度(Sp O_2)、平均动脉压(MAP)、心率、舒张压、麻醉时间、手术时间、功醒时间、自主呼吸恢复时间、意识恢复时间、拔管时间及并发症发生情况。结果观察组心率T_2、T_3及T_4呈下降趋势,对照组心率呈波动趋势;两组舒张压呈T_2下降T_3及T_4升高的趋势;观察组MAP不同时间点的无明显波动,对照组呈T_2、T_3升高T_4下降的趋势,明显波动。两组心率、舒张压、MAP的组间、不同时点间、组间·不同时点间的交互作用比较差异均有统计学意义(P0.05)。观察组麻醉时间和苏醒时间显著短于对照组[(67±6)min比(91±7)min,(9.7±2.0)min比(15.3±2.7)min],差异有统计学意义(P0.05)。观察组自主呼吸恢复时间显著短于对照组[(1.6±0.4)min比(2.5±0.6)min],差异有统计学意义(P0.05)。观察组恶心呕吐、呼吸抑制、唤醒时痛感的发生率均显著低于对照组[4.9%(2/41)比24.4%(10/41),2.4%(1/41)比29.3%(12/41),4.9%(2/41)比31.7%(13/41)],差异有统计学意义(P0.05)。结论七氟烷复合丙泊酚用于小儿斜视矫正手术患儿效果显著,麻醉时间短,唤醒时间短,稳定血流动力学状态,且并发症少,临床应用安全可靠,值得临床上进一步推广应用。
[Abstract]:Objective to investigate the anesthetic effect and safety of sevoflurane combined with propofol in pediatric strabismus correction.Methods from October 2007 to April 2015, 82 children undergoing strabismus correction were divided into observation group (n = 41) and control group (n = 41).The observation group received continuous intravenous infusion of 5% sevoflurane and 6 mg/(kg / h) propofol anesthesia, while the control group maintained the anesthesia by continuous intravenous infusion of ketamine 2.5 mg/(kg / h.The mean arterial pressure (MAPP), heart rate (HR), diastolic blood pressure (DBP), anesthesia time, operation time, wakeup time, spontaneous respiration recovery time, consciousness recovery time, extubation time and complications were compared between the two groups.Results the heart rate T _ 2C _ 3 and T _ 4 of the observation group showed a downward trend, while the heart rate of the control group showed a trend of fluctuation; the diastolic pressure of the two groups showed a tendency of decreasing T _ 3 and T _ 4; the MAP of the observation group had no obvious fluctuation at different time points, while the control group showed a tendency of increasing T _ (4) in T _ 2O _ T _ 3, and the diastolic blood pressure of the two groups showed a tendency of increasing T _ 3 and T _ 4.Obviously fluctuate.There were significant differences in the interaction between the two groups in heart rate, diastolic pressure and map, at different time points and at different time points (P 0.05).The anaesthesia time and recovery time in the observation group were significantly shorter than those in the control group [67 卤6)min vs 91 卤7 2.0)min vs 15.3 卤2.7)min]. The difference was statistically significant (P 0.05).The recovery time of autonomic respiration in the observation group was significantly shorter than that in the control group [1.6 卤0.4)min vs 2.5 卤0.6)min], and the difference was statistically significant (P 0.05).Conclusion sevoflurane combined with propofol is effective in the correction of strabismus in children with short anesthesia time, short arousal time, stable hemodynamic state, less complications, safe and reliable clinical application, and worthy of further clinical application.
【作者单位】：湖北省妇幼保健院眼科;
【分类号】：R726.1

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