摘要:目的:分析與比較七氟醚吸入麻醉和丙泊酚靜脈復合麻醉應用于三聚氰胺致嬰幼兒輸尿管結石手術的麻醉效果。方法:60例輸尿管結石患兒隨機分為七氟醚(Sev)組(n=30)和丙泊酚(Pro)組(n=30)。觀察并記錄誘導時間、氣管內插管時間、蘇醒時間、拔除氣管插管時間、PACU滯留時間。記錄麻醉誘導和蘇醒期的不良反應。另外記錄兩組病人誘導前、插管前、插管后3 min、5 min、15 min、30 min時點的血壓、心率、脈搏血氧飽和度(SPO2)。結果:七氟醚組誘導時間(63.2±6.9)s長于丙泊酚組(38.2±12.7)s,七氟醚組拔除氣管插管時間(11.9±4.7)min短于丙泊酚組(15.6±8.2)min,兩組相比有統計學意義(P lt;0.05)。七氟醚組躁動發生率53.3%顯著高于丙泊酚組13.3%(P lt;0.01)。七氟醚組在插管前、插管后各時點的血壓、心率與誘導前相比,差異無統計學意義(P gt;0.05),丙泊酚組插管前、插管后3 min、5 min與誘導前相比血壓、心率顯著降低(P lt;0.05),與同時間點七氟醚組相比血壓顯著降低(P lt;0.05)。結論:兩種麻醉方法均可安全有效用于嬰幼兒輸尿管結石手術,七氟醚組血流動力學更平穩,但躁動發生率較高。
Abstract: Objective: To analyze and compare sevoflurane with propofol for anesthesia in infants with Melamineinduced ureteral stone surgery. Methods: Sixty infants who were to undergo Melamineinduced ureteral stone surgery were randomly divided into sevoflurane (Sev) group (n=30) and propofol (Pro) group (n=30). Observe and record the induction of anesthesia time, intubation time, awakening time, time to extubation, time to stay at PACU. Record adverse effects during induction of anesthesia and the awake period. In addition, recorded BP, HR, SPO2 of two groups before induction and intubation, after 3min、5min、15min、30min　after intubation. Results: Induction time ［（63.2 ± 6.9） s］ in sevoflurane group was longer than propofol group ［(38.2±12.7） s］,but extubation time ［（11.9 ± 4.7） min］ was shorter than propofol group ［(15.6 ± 8.2） min］, there was significantly different between two groups (P lt;0.05). The incidence of restlessness in sevoflurane group 53.3% was significantly higher than propofol group 13.3% (P lt;001). In sevoflurane group the BP, HR before intubation compare with after intubation has no significant difference (P gt;0.05). Compared with before induction,the BP, HR before induction, after intubation 3 min, 5 min, decreased significantly (P lt;0.05) in propofol group.when compared the same point with sevoflurane group, blood pressure decreased significantly (P lt;0.05). Conclusion: Both propofol and sevoflurane can be used effectively and safely for anesthesia of ureteral calculi stone surgery in pediatric. The hemodynamics is more stable but restlessness is more common in sevoflurane group.

Citation： BULIKEMU Aimaiti,ZHANG Qin,ZHENG Hong.. Clinical Comparision of the Effects of Two Different Anesthesia for Surgery of Pediatric Ureteral Calculi. West China Medical Journal, 2009, 24(11): 2873-2875. doi: Copy

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