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目的分析七氟醚在小儿口腔、鼻咽部肿物手术全麻中的应用。方法 60例年龄3～14岁小儿患者随机均分为两组接受气管插管全麻:Ⅰ组使用8%七氟醚诱导,3%浓度维持;Ⅱ组采用8%七氟醚,芬太尼3μg/kg,阿曲库胺0.4mg/kg诱导,3%七氟醚维持。监测术前、切肿物时、手术开始后15、30、60min及手术结束时的心率、血压。记录诱导至插管时间、停药至自主呼吸恢复时间和术毕至拔管时间。结果Ⅰ组诱导至插管时间长于Ⅱ组(P<0.05),停药至自主呼吸恢复时间以及术毕至拔管时间明显短于Ⅱ组(P<0.01)。与术前相比Ⅱ组切肿物时、手术开始后15min的心率减慢、血压降低(P<0.05);与Ⅱ组比较,Ⅰ组切除肿物时、手术开始15min的心率明显增快、血压明显升高(P<0.05)。结论 8%七氟醚诱导、3%七氟醚维持全凭吸入麻醉较七氟醚静吸复合麻醉安全性高。
Objective To analyze the application of sevoflurane in general anesthesia of oral and nasopharyngeal tumor in children. Methods Sixty pediatric patients aged 3-14 years were randomly divided into two groups: general anesthesia with tracheal intubation: group Ⅰ was induced with 8% sevoflurane and maintained with 3% concentration; group Ⅱ with 8% sevoflurane, fentanyl 3μg / kg, atracurium 0.4mg / kg induction, 3% sevoflurane maintenance. Monitoring preoperative, tumor removal, the beginning of surgery 15,30,60 min and the end of the surgery when the heart rate, blood pressure. Induction to intubation time, withdrawal to spontaneous breathing recovery time and surgery to extubation time. Results The induction time to intubation in group Ⅰ was longer than that in group Ⅱ (P <0.05). The time from withdrawal to spontaneous respiration and the time from operation to extubation were significantly shorter than those in group Ⅱ (P <0.01). Compared with preoperative group Ⅱ, the heart rate decreased and blood pressure decreased 15 min after operation (P <0.05). Compared with group Ⅱ, the heart rate of 15 min after operation was significantly increased in group Ⅰ when the tumor was removed. Blood pressure was significantly higher (P <0.05). Conclusion 8% sevoflurane induction, 3% sevoflurane maintenance anesthesia than sevoflurane inhalation anesthesia combined with high safety.