摘要
目的探讨8％七氟烷吸入诱导麻醉代替氯胺酮肌肉注射基础麻醉在小儿麻醉中的安全性和有效性。方法择期手术的患儿60例，ASAⅠ～Ⅱ级，随机分为两组。Ⅰ组：氯胺酮肌肉注射基础麻醉＋骶管阻滞组；Ⅱ组：8％七氟烷吸入诱导麻醉＋骶管阻滞组。分别记录患儿从清醒到意识消失的时间、骶管穿刺过程中的体动反应、术后清醒的时间和其间MAP、HR、SpO2变化，以及不良反应发生率。结果Ⅱ组从清醒到意识消失的时间、术后清醒的时间显著短于Ⅰ组（P〈0．01）；两组骶管穿刺过程中均未见体动反应；Ⅱ组MAP、HR无明显变化，Ⅰ组MAP、HR明显上升（P〈0．05），两组SpO2变化差异无统计学意义：工组不良反应多于Ⅱ组（P〈0．05）。结论8％七氟烷吸入诱导麻醉在ASAⅠ-Ⅱ级患儿是安全有效的，代替氯胺酮肌肉注射基础麻醉是可行的，对不合作的儿童尤为适用。
Objective To investgate the safety and efficacy whether ketamine intramuscular injection basic anesthesia can be substituted by induction with inhalation of 8%sevoflurane.Methods 60 chlidren patients（,ASA physical status Ⅰ and Ⅱ ）undergoing selective operations were divided randomly into two groups： ketamine intramnscular injection basic anesthesia combined with caudal block group（group Ⅰ ）and induction with inhalation of 8% sevoflurane combined with caudal block group（group Ⅱ ）.Time to loss,the reaction during caudal block, time to awakening were recorded.MAP, HR and SpO2 were recorded before anesthesia and one minute,two minute,three minute after anesthesia and the end of opertation.Nasea and vomiting,drowsiness,restlessness were also recorded. Results Time to loss and time to awakening were shorter in group Ⅱ than that in group Ⅰ. There was no reaction during caudal block in two groups. The changes of MAP, HR in group Ⅰ increased significantly than that in group Ⅱ. There were no significant difference in SpO2 between two groups. Compared with group Ⅰ, there was less side effect in group Ⅱ . Conclusion Induction with inhalation of 8% sevoflurane could provide safe and effective anesthesia in ASA physical status Ⅰ and Ⅱ pediatric surgery.Ketamine intramuscular injection basic anesthesia can be substituted efficiently by induction with inhalation of 8 % sevoflurane.
出处
《四川医学》
CAS
2009年第1期45-47,共3页
Sichuan Medical Journal
关键词
七氟烷
氯胺酮
小儿
麻醉诱导
sevoflurane
ketamine
pediatric surgery
induction of anesthesia
