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目的比较经喉罩七氟醚吸入麻醉与传统氯胺酮复合麻醉在小儿先天性髋关节脱位手术中的优缺点。方法将ASA Ⅰ～Ⅱ级拟在全麻下行先天性髋关节脱位手术的40例年龄2～4岁患儿随机分为A组(经喉罩七氟醚吸入麻醉组)和B组(氯胺酮复合麻醉组),观察比较两组患儿手术过程中患儿心率(HR)变化、肢体活动、血氧饱和度(SpO2)、呼吸频率(RR)、术毕苏醒时间及围术期不良反应。结果 A组患儿手术过程中发生肢体活动明显低于B组(P<0.01),心率变化超过20%的患儿A组低于B组(P<0.05),两组患儿术中SpO2和呼吸频率差异无统计学意义(P>0.05),A组术毕清醒时间明显短于B组,A组围术期不良反应也大大低于B组。结论经喉罩七氟醚吸入麻醉安全可靠,效果确切,明显优于氯胺酮复合麻醉,可作为小儿先天性髋关节脱位矫形手术的适宜麻醉。
Objective To compare the advantages and disadvantages of anesthesia with laryngeal mask sevoflurane anesthesia and traditional ketamine anesthesia in children with congenital dislocation of the hip. Methods A total of 40 children aged 2 to 4 years old with ASA Ⅰ ~ Ⅱ undergoing general anesthesia for congenital dislocation of the hip joint were randomly divided into group A (anesthesia with laryngeal mask sevoflurane inhalation) and group B (ketamine compound (HR), physical activity, oxygen saturation (SpO2), respiration rate (RR), time of recovery from operation and perioperative adverse reactions were observed and compared in the two groups. Results The physical activity in group A was significantly lower than that in group B (P <0.01). The group A with less than 20% change in heart rate was lower than that in group B (P <0.05) There was no significant difference in respiratory rate (P> 0.05). The awake time of group A was shorter than that of group B, and the perioperative adverse reaction in group A was also lower than that of group B. Conclusion The laryngeal mask sevoflurane inhalation anesthesia is safe and reliable, the effect is definite, which is obviously better than ketamine combined anesthesia. It can be used as appropriate anesthesia for pediatric congenital dislocation of hip joint.