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目的观察小儿电子耳蜗植入术应用喉罩单纯吸入麻醉及全凭静脉麻醉中的安全性及不良反应。方法选择行电子耳蜗植入术患儿168例,随机分为单纯吸入全身麻醉组和全凭静脉全身麻醉组。记录患儿入室时刻(T1)、入睡后安静状态(T2)、喉罩插入前(T3)、喉罩插入后(T4)、喉罩拔出前(T5)、喉罩拔出后时刻(T6)的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)、脑电双频指数(BIS)、苏醒时间(停药后到拔出喉罩所需时间)及不良反应发生率。结果两组在各时间点所测量的指标均无显著性差异。两组患儿T1、T2时刻HR组内比较有显著性差异[(148.8±18.5)次/min vs.(130.2±10.80)次/min,P<0.05;(150.2±20.7)次/min vs.(100.6±17.2)次/min,P<0.05]。两组苏醒时间无显著性差异。不良反应单纯吸入全身麻醉组17例,全凭静脉全身麻醉组15例,两组无显著性差异。结论单纯吸入全身麻醉或全凭静脉全身麻醉中喉罩应用于小儿电子耳蜗植入术是安全的,能避免气管内插管而产生的不良反应。
Objective To observe the safety and adverse reactions of laryngeal mask inhalation anesthesia and total intravenous anesthesia in pediatric cochlear implantation. Methods 168 children with cochlear implants were randomly divided into general anesthesia group and total intravenous anesthesia group. (T1), resting state after sleep (T2), pre-laryngeal mask insertion (T3), laryngeal mask insertion (T4), laryngeal mask extraction (T5), laryngeal mask extraction time ), Mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), end-tidal carbon dioxide pressure (PETCO2), bispectral index (BIS), wake time Out of laryngeal mask time) and the incidence of adverse reactions. Results There was no significant difference between the two groups measured at all time points. There was a significant difference in HR group between the two groups at T1 and T2 [(148.8 ± 18.5) times / min vs. (130.2 ± 10.80) times / min, P <0.05; (150.2 ± 20.7) times / min vs. (100.6 ± 17.2) times / min, P <0.05]. There was no significant difference between the two groups in wake time. Adverse reactions Pure inhalation of 17 cases of general anesthesia, total intravenous anesthesia in 15 cases, no significant difference between the two groups. Conclusion The application of laryngeal mask to pediatric cochlear implantation in purely inhaled general anesthesia or total intravenous anesthesia is safe and avoids the adverse reactions caused by endotracheal intubation.