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目的探讨七氟醚丙泊酚对儿童短小手术的麻醉效果。方法 30例择期手术患儿随机分为Ⅰ、Ⅱ两组,每组15例。Ⅰ组用七氟醚吸入诱导并维持麻醉,Ⅱ组行氯胺酮基础麻醉并在术中间断静脉推注氯胺酮1-2mg/kg维持麻醉;两组均辅以丙泊酚5mg·kg-1·h-1维持。记录患儿诱导后(T1)、手术切皮时(T2)、手术开始后10min(T3)的HR、MAP、SpO2;记录改良Aldrete评分达9分所需时间;观察术后谵妄躁动、恶心、呕吐等不良反应的发生情况。结果两组患儿各时点SpO2均无明显改变,Ⅰ组术中MAP、HR低于Ⅱ组(P<0.05);Ⅰ组改良Aldrete评分达9分时间低于Ⅱ组[(3.8±2.0)min vs.(7.9±2.4)min](P<0.01);Ⅰ组苏醒期谵妄躁动2例,Ⅱ组苏醒期谵妄躁动9例;两组均未见明显苏醒期呕吐。结论丙泊酚复合七氟醚麻醉效果好,血流动力学稳定,术后谵妄躁动少,适合儿童短小手术。
Objective To investigate the anesthetic effect of sevoflurane propofol on children’s short operation. Methods Thirty patients undergoing elective surgery were randomly divided into two groups: Ⅰ and Ⅱ, with 15 cases in each group. Group Ⅰ was induced by inhalation of sevoflurane and maintained anesthesia. Group Ⅱ was anesthetized with ketamine and intermittent intravenous ketamine (1-2mg / kg) during operation. Both groups were supplemented with propofol 5mg · kg-1 · h -1 to maintain. The HR, MAP and SpO2 of the children after induction (T1), surgical incision (T2) and 10 min after the start of surgery (T3) were recorded. The time required for the modified Aldrete score to reach 9 was recorded. Postoperative delirium, nausea, Vomiting and other adverse reactions occurred. Results There was no significant difference in SpO2 between two groups at each time point. MAP and HR in group Ⅰ were lower than those in group Ⅱ (P <0.05); Group Ⅰ improved Aldrete score was 9 and lower than group Ⅱ [(3.8 ± 2.0) min (7.9 ± 2.4) min] (P <0.01). There were 2 cases of delirious delirium in group Ⅰ and 9 cases of delirium of delirium in group Ⅱ. There was no obvious vomiting in both groups. Conclusion Propofol sevoflurane anesthesia, hemodynamic stability, postoperative delirium less agitation, suitable for short-term surgery in children.