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目的:观察等效剂量地佐辛或芬太尼在七氟醚全凭吸入麻醉下小儿疝气手术的临床疗效。方法:60例择期行小儿双侧疝气手术患儿,年龄3-5岁,体重13-20 kg,ASA I级,随机分为地佐辛组(D组)和芬太尼组(F组)(n=30),均实施七氟醚全凭吸入麻醉,保留自主呼吸。在插喉罩前5min分别静脉注射地佐辛0.1mg/kg(D组)、芬太尼2μg/kg(F组)。观察两组患儿诱导前(T0)、插喉罩前1min(T1)、插喉罩后即刻(T2)、插喉罩后5min(T3)和拔喉罩后1min(T4)、5min(T5)、15min(T6)的HR、MAP、SpO2、ETCO2、潮气量(VT)、呼吸频率(RR)变化及术后苏醒情况。结果:两组患儿的手术时间、麻醉时间、HR、MAP、SpO2等组间比较无统计学差异(P>0.05)。与T0比较,D组T3-T5ETCO2增高,T1、T3RR减少(P<0.05),F组T2-T5ETCO2增高,T1-T4RR减少(P<0.05);与F组比较,D组T3-T5ETCO2较低(P<0.05),术后苏醒时间较长,镇静满意率较高,术后躁动发生率较低(P<0.05)。结论:地佐辛复合七氟醚可安全用于小儿疝气手术的麻醉,较芬太尼能降低术后不良反应的发生率。
Objective: To observe the clinical efficacy of dezocine or fentanyl at equivalent doses in pediatric hernia surgery under anesthesia with sevoflurane alone. Methods: Sixty children undergoing bilateral hernia surgery, aged 3-5 years and weighing 13-20 kg, were randomly divided into dezocine group (D group) and fentanyl group (F group) (n = 30). All patients were anesthetized with sevoflurane and inhaled spontaneously. Five minutes before the laryngeal mask, dezocine 0.1 mg / kg (group D) and fentanyl 2 μg / kg (group F) were injected intravenously. (T0), 1min before insertion of laryngeal mask (T1), immediately after insertion of laryngeal mask (T2), 5min after insertion of laryngeal mask (T3) and 1min after pulling laryngeal mask (T4), 5min HR, MAP, SpO2, ETCO2, tidal volume (VT) and respiratory rate (RR) at 15min (T6) and postoperative recovery. Results: There was no significant difference in the operation time, anesthesia time, HR, MAP and SpO2 among the two groups (P> 0.05). Compared with T0, T3-T5ETCO2 increased, T1 and T3RR decreased in group D (P <0.05), T2-T5ETCO2 increased and T1-T4RR decreased in group F (P <0.05) (P <0.05). The postoperative recovery time was longer, the satisfaction rate of sedation was higher, the incidence of postoperative agitation was lower (P <0.05). Conclusion: Dezocine in combination with sevoflurane can be safely used in pediatric hernia surgery anesthesia, fentanyl can reduce the incidence of postoperative adverse reactions.