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目的比较喉罩通气下七氟醚全凭吸入麻醉与氯胺酮及丙泊酚复合麻醉用于小儿先天性心脏病介入手术的优劣。方法选择60例择期行先天性心脏病介入手术的患儿,随机分为S、P 2组,S组:全凭七氟醚诱导、维持,喉罩通气;P组:氯胺酮诱导,全凭丙泊酚维持,面罩吸氧。记录麻醉诱导前(T1)、手术开始时(T2)及手术结束时(T3)各时点患儿SBP、DBP、MAP、HR、SpO2,观察手术结束至患儿清醒的时间及术后并发症(恶心、呕吐、躁动)的发生率。结果与P组比较,S组患儿T2时刻SBP、MAP、HR明显降低(P<0.05),T1、T3时刻SBP、DBP、MAP、HR差异无统计学意义(P>0.05);2组T2、T3时刻SBP、DBP、MAP、HR均较各自组T1时刻无明显变化(P>0.05);2组患儿各时点SpO2差异均无统计学意义(P>0.05)。S组清醒时间明显低于P组(P<0.05)。2组术后并发症发生率无明显差异(P>0.05)。结论喉罩通气下七氟醚全凭吸入麻醉应用于小儿先天性心脏病介入手术,比氯胺酮及丙泊酚复合麻醉更安全有效。
Objective To compare the advantages and disadvantages of anesthesia with sevoflurane anesthesia combined with ketamine and propofol under laryngeal mask ventilation in pediatric congenital heart disease interventional surgery. Methods Sixty children with elective cardiac intervention were randomly divided into S, P 2 and S groups: induced and maintained by sevoflurane, ventilation of laryngeal mask; group P: induced by ketamine, Phenol to maintain, mask oxygen. The SBP, DBP, MAP, HR and SpO2 were recorded before anesthesia induction (T1), at the beginning of surgery (T2) and at the end of surgery (T3), and the time between the end of operation and awakening of the child and the complication (Nausea, vomiting, agitation) the incidence. Results Compared with group P, the SBP, MAP and HR of group S were significantly decreased at T2 (P <0.05), but there was no significant difference of SBP, DBP, MAP and HR at T1 and T3 (P> 0.05) , SBP, DBP, MAP and HR at T3 were not significantly different from those at T1 (P> 0.05). There was no significant difference in SpO2 between the two groups at each time point (P> 0.05). S group awake time was significantly lower than the P group (P <0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusion Sevoflurane anesthesia with laryngeal mask ventilation in pediatric congenital heart disease intervention, ketamine and propofol anesthesia more safe and effective.