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目的研究七氟醚诱导气管插管减轻短期内行两次手术的脑性瘫痪患儿术前焦虑的效果。方法 2009年12月-2011年7月选择需要短期内行两次全身麻醉(全麻)手术的痉挛性脑性瘫痪患儿60例,美国麻醉医师协会(ASA)Ⅰ～Ⅱ级。随机分为A组常规麻醉诱导气管插管(30例)和B组七氟醚诱导气管插管(30例);分别在一期及二期手术术前访视时(M1、M3)、入手术室时(M2、M4)对两组患儿进行改良耶鲁围术期焦虑量表评估;并分别在一期及二期手术麻醉诱导期(N1、N2)对两组患儿进行诱导期合作度量表的标准评定。结果同组一期、二期手术比较,A组患儿二期手术术前焦虑更明显(P<0.05),二期入手术室时焦虑更明显(P<0.05),二期手术合作度更差(P<0.05);B组患儿两次手术术前焦虑无明显变化(P>0.05),一期入手术室时焦虑明显(P<0.05),一期手术合作度较差(P<0.05)。两组之间,一期手术两组患儿焦虑情况无明显区别(P>0.05),二期手术A组比B组的患儿焦虑更明显(P<0.05),两次手术B组都比A组的患儿合作度更好(P<0.05)。结论七氟醚麻醉诱导气管插管能够有效减轻短期内需要进行两次手术的痉挛性脑性瘫痪患儿的术前焦虑,提高患儿二期手术的合作度,提供良好的手术麻醉条件,保证患儿的围术期安全。
Objective To study the effect of sevoflurane-induced endotracheal intubation on preoperative anxiety in children with cerebral palsy who underwent two operations in short term. METHODS: From December 2009 to July 2011, 60 children with spastic cerebral palsy requiring short-term general anesthesia (general anesthesia) surgery were selected, and American Society of Anesthesiologists (ASA) Ⅰ ~ Ⅱ were selected. Randomly divided into group A, conventional anesthesia-induced endotracheal intubation (30 cases) and group B, sevoflurane-induced endotracheal intubation (30 cases). During the first and second phases of operation, At the operating room (M2, M4), the modified Yale Perioperative Anxiety Scale was evaluated in both groups. The two groups of children were induced during the induction phase (stage N1 and stage N2) Metric standard assessment. Results Compared with the first stage and the second stage of operation, the anxiety in the second stage operation was more obvious in group A (P <0.05), the second stage operation room anxiety was more obvious (P <0.05), the second stage operation cooperation degree was more (P <0.05). There was no significant difference in preoperative anxiety between the two groups in group B (P> 0.05). One group had significant anxiety (P <0.05) in the operating room and a poor degree of cooperation in the first stage (P < 0.05). There was no significant difference (P> 0.05) between the two groups in the anxiety of the two groups (P> 0.05), and the anxiety of the two groups was more obvious than that of the B group (P <0.05) Children in group A had better co-operation (P <0.05). Conclusion Sevoflurane induced tracheal intubation can effectively reduce preoperative anxiety in children with spastic cerebral palsy who need two surgeries in a short period of time, improve the cooperation degree of second stage surgery and provide good anesthetic conditions for operation, and ensure Perioperative safety of children.