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目的探讨七氟醚(SF)单纯面罩吸入与合用笑气(N2O)在非住院小儿包皮环切手术中的麻醉效果。方法选择60例包皮环切小儿,ASAⅠ级,随机分为3组(各20例),A组单纯SF面罩吸入麻醉,B组SF加N2O面罩吸入麻醉,C组SF加N2O吸入麻醉,术后局部注射2%利多卡因镇痛。观察并比较3组诱导前、诱导时、术中、术毕时的脉率(PR)、脉搏血氧饱和度(SpO2)以及诱导时睫毛反射消失时间、完全清醒时间和不良反应。结果与诱导前相比,诱导及术毕时3组PR无明显变化(P>0.05),术中显著升高(P<0.05);3组内及各组内各时点比较SpO2差异无统计学意义(P>0.05)。3组睫毛反射消失时间差异无统计学意义;A、C组各1例,B组2例出现躁动;A、C组各1例出现喉痉挛;无1例出现拒吸、呛咳。3组术后完全清醒时间差异无统计学意义;36例患儿出现术后啼哭,A组18例,B组17例,C组1例;A组4例躁动,B组3例,2组患儿全诉疼痛,C组仅2例诉疼痛,无1例躁动,3组术后均无恶心呕吐。结论SF易被小儿接受,诱导、恢复快,过程平顺,并发症少,是小儿非住院短小手术全身麻醉较为理想的吸入麻醉药。
Objective To investigate the anesthetic effect of simple mask inhalation of sevoflurane (SF) combined with nitrous oxide (N2O) in non-hospitalized children with circumcision. Methods Sixty children with circumcised circumfluence were enrolled and divided into three groups (20 in each ASA) randomly. Group A was inhaled anesthetized with SF mask only. Group B was anesthetized with SF plus N2O mask. Group C was anesthetized with SF plus N2O. Local injection of 2% lidocaine analgesia. Observed and compared the pre-induction, induction, intraoperative and postoperative pulse rate (PR), pulse oximetry (SpO2), and induced disappearance of eyelashes reflection time, complete awake time and adverse reactions. Results There was no significant change in PR between the three groups at induction and at the time of operation (P> 0.05), but the difference was not statistically significant Significance (P> 0.05). There was no significant difference in the disappearance time of eyelash reflex between the three groups. There were 1 case in group A and group C, 2 cases in group B, and 1 case laryngospasm in group A and group C, respectively. There were no significant differences in the complete awake time between the three groups after surgery; 36 patients had cry after surgery, 18 cases in group A, 17 cases in group B and 1 case in group C; 4 cases were agitation in group A, 3 cases in group B and 2 cases in group B Children complained of pain, C group, only 2 cases complained of pain, no restlessness in 1 case, no nausea and vomiting in 3 groups. Conclusion SF is easy to be accepted in children, induction, rapid recovery, the process is smooth, less complications, is a better non-hospital short-term general anesthesia inhalation anesthetics.