文章摘要

不同浓度七氟醚潮气量法吸入诱导对小儿扁桃体、腺样体摘除术苏醒期躁动的影响

作者: 1汪俊, 1叶宏武
1 安徽省儿童医院麻醉科,合肥 230051
通讯: 汪俊 Email: wjdd163@163.com
DOI: 10.3978/j.issn.2095-6959.2020.08.029

摘要

目的:观察不同浓度七氟醚潮气量法吸入诱导对小儿扁桃体、腺样体摘除术患者苏醒期躁动的影响。方法:选择择期行扁桃体、腺样体摘除手术患儿90例,按照随机数表法分为S1组、S2组和D组,每组30例。S1组、S2组患儿行不同浓度七氟醚吸入诱导至意识消失后转入手术室,追加静脉诱导行气管插管,D组直接采用静脉诱导气管插管。观察3组患儿入室时(T0)、睫毛反射消失时(T1)、插管时(T2)、拔管时(T3)的平均动脉压(mean arterial blood pressure,MAP)、心率(heart rate,HR),记录3组患者的手术时间、手术结束后自主呼吸恢复时间并进行苏醒期躁动评分。记录吸入诱导组(S1组、S2组)睫毛反射消失所需时间、患儿诱导期间的合作程度评分。结果:3组患儿一般资料比较差异无统计学意义(P>0.05),与T0比较,D组MAP,HR均下降(P<0.05),S1组、S2组患儿MAP,HR均上升(P<0.05),与D组比较,在T1时点MAP,HR均上升(P<0.05)。3组患儿手术时间、苏醒时间、苏醒期躁动评分均差异无统计学意义(P>0.05)。与S1组比较,S2组睫毛反射消失时间、诱导期合作度(induction compliance checklist,ICC)评分均降低(P<0.05)。结论:不同浓度七氟醚潮气量法吸入诱导对小儿扁桃体、腺样体摘除术后苏醒期躁动无明显影响,低浓度诱导时间长循环波动较大。
关键词: 七氟醚;吸入诱导;全身麻醉;儿童;苏醒期躁动

Effect of inhalation induced by tidal volume method of sevoflurane with different concentration on emergence agitation in children with adenotonsillectomy

Authors: 1WANG Jun, 1YE Hongwu
1 Department of Anesthesiology, Anhui Provincial Children’s Hospital, Hefei 230051, China

CorrespondingAuthor: WANG Jun Email: wjdd163@163.com

DOI: 10.3978/j.issn.2095-6959.2020.08.029

Abstract

Objective: To observe the effect of inhalation induction of sevoflurane with different concentration on emergence agitation in children with adenotonsillectomy. Methods: We selected 90 cases of children with tonsillar and adenoidectomy and divided into S1, S2 and D groups according to the random number table, 30 cases in each group. Patients in groups S1 and S2 were induced by inhalation of sevoflurane at different concentrations until their consciousness disappeared and then transferred to the operating room, followed by intravenous induction and endotracheal intubation. and patients in group D received direct intravenous induction of endotracheal intubation. MAP and HR of patients in the three groups at the time of admission (T0), disappearance of eyelash reflex (T1), intubation (T2) and extubation (T3) were observed. The operation time and recovery time of spontaneous breathing after the operation were recorded for patients in the three groups. The time required for the disappearance of eyelash reflex in the inhalation induction group (S1 group and S2 group) and the score of cooperation degree during the induction of children were recorded. Results: There was no statistical difference in the general information of children in the three groups (P>0.05). Compared with T0, MAP and HR in group D decreased (P<0.05), while MAP and HR in group S1 and S2 increased (P<0.05). Compared with group D, MAP and HR in group T1 increased (P<0.05). There was no significant difference in the scores of operation time, wake time and emergence agitation among the three groups (P>0.05). Compared with group S1, both the disappearance time of eyelash reflex and ICC score of induction period in group S2 were decreased (P<0.05). Conclusion: Inhalation induction with different concentration of sevoflurane has no obvious effect on emergence agitation in children with adenotonsillectomy.
Keywords: sevoflurane; induction inhalation; general anesthesia; children; emergence agitation