摘要
目的比较七氟烷吸入诱导和舒芬太尼静脉诱导时先天性心脏病患儿乳酸水平的变化,探讨七氟烷吸入诱导对先天性心脏病患儿安全性的影响。方法将非紫疳型先天性心脏病患儿分为七氟烷吸入诱导试验组27例,舒芬太尼诱导对照组26例。试验组患儿吸入1.5最低肺泡有效浓度(MAC)七氟烷,经静脉给予维库溴胺0.2 mg/kg,维持吸入七氟烷10 min后气管插管,插管后10 min(T1)抽取动脉血检测乳酸值,然后停用七氟烷,改用静脉泵入静安2 mg/(kg·h)、舒芬太尼1μg/(kg·h);气管插管后30 min(T2)后复查动脉血乳酸值。对照组予以静脉注入静安2 mg/kg、舒芬太尼1μg/kg、维库溴胺0.2 mg/kg,气管插管后,继续舒芬太尼、静安维持,静脉注入速度与试验组相同,在对应的T1、T2点查动脉血乳酸值,记录心率、平均动脉压。结果试验组T1点乳酸值(1.25±0.51)mmol/L,为2组各时点最高值;试验组内比较T1点乳酸值、心率均明显高于T2点(P<0.05),而平均动脉压无差异;组间比较T1点乳酸值、心率明显高于对照组(P<0.05)。结论七氟烷吸入诱导后乳酸水平高于舒芬太尼诱导,但2组患儿乳酸水平均在正常范围。
Objective To explore the safety and influence of sevoflurane inhalation induction on lactic acid level in children with congenital heart disease. Methods Children with non- cyanotic type congenital heart disease were divided into trial group （ n = 27, sevoflurane inhalation induction） and control group （n = 26, sufentanil induction）. The trial group was treated with 1.5 MAC sevoflurane, vecuronium bromide amine 0.2 mg/kg, maintained for 10 minutes, trachea cannula af- ter 10 minutes （T1）, lactic acid value detected by smoke arterial blood detection. Disable sevoflu- rane inhalation, convert propofol 2 mg/（kg· h）, sufentanil 1μg/（kg· h） vein pump into, after 20 minutes （T2）, （namely endotracheal intubation after 30 minutes）, review arterial blood lactic acid value. The control group was treated with propofol 2 mg/kg, sufentanil 1μg/kg, vecuronium bro- mide amine 0.2 mg/kg, induced after intubation, continue to sufentanil, propofol maintain, the in- travenous injection speed was the same as the trial group. Arterial blood lactic acid value was checked in the time points of T1 and T2. Results In the T1 point, lactic acid value in the trial group was （1.25 ± 0.51） mmol/L, which was the highest level in all the time points and all the groups. Lactic acid value and HR in T1 point in the trial group heart rate were significantly higher than those in T2 point in the same group（P〈 0.05）, and they were also significantly higher than those in the same time points in the control group （P 〈 0.05）. Conclusion Lactic acid level by sevoflurane induction is higher than that by sufentanil induction.
出处
《实用临床医药杂志》
CAS
2014年第3期36-38,共3页
Journal of Clinical Medicine in Practice
关键词
乳酸
七氟烷
麻醉诱导
先天性心脏病
小儿
lactic acid
sevoflurane
anesthesia induction
congenital heart disease
chil-dren
