喉罩下七氟醚联合瑞芬太尼在小儿尿道下裂手术中的应用-论文.pdf

《喉罩下七氟醚联合瑞芬太尼在小儿尿道下裂手术中的应用-论文.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、中国当代医药2014年9月第2l卷第27期·麻醉与镇痛·喉罩下七氟醚联合瑞芬太尼在d,JL尿道下裂手术中的应用潘守清李家铁孙成亮江苏省连云港市第一人民医院麻醉科，江苏连云港222002【摘要】目的研究喉罩下七氟醚联合瑞芬太尼在A,JL尿道下裂手术中的应用效果。方法选择择期行尿道下裂成形术的患儿4O例，ASAI一Ⅱ级，年龄2~6岁，体重10～26kg，将其随机分为喉罩麻醉组(L组)和气管插管麻醉组(T组)，每组各20例。以丙泊酚及顺式阿曲库铵行麻醉诱导，分别插入喉罩或气管导管，术中以七氟醚联合瑞芬太尼维持麻醉，观察插管与拔管即刻患儿平均动脉压(MAP)、心率(HR)的变化以及术中患儿体动、

2、术后恶心呕吐、苏醒期躁动的发生率。结果L组患儿插管前后的HR与MAP变化差异无统计学意义(P>0．05)。T组患儿插管后以及拔管时的MAP和HR显著高于L组，发生苏醒期躁动的比率明显增高，差异有统计学意义(P<0．05)。结论喉罩麻醉在小儿尿道下裂手术中可安全取代气管插管，诱导苏醒平稳，苏醒期躁动等不良反应少。[关键词】喉罩；小儿；七氟醚；尿道下裂；瑞芬太尼；麻醉【中图分类号】R614．21【文献标识码】A【文章编号】1674—4721(2014)09(c)一0095—03Applicationoflaryngealmaskinhalationsevofluraneanesthesiac

3、ombinedwithremifentanilinchildrenundergoinghypospadiasrestitutionPANShou——qingLIJia-tieSUNCheng-liangDepartmentofAnesthesia，theFirstPeopleSHospitalofLianyungangCityinJiangsuProvince，Lianyungang222002，China【Abstract]ObjectiveTostudytheefficacyoflaryngealmaskinhalationsevofluraneanesthesiacombinedw

4、ithremifen—tanilinchildrenundergoinghypospadiasrestitution．MethodsFortychildrenwithhypospadiasplastyagedtoselectagoodtimewereselected，ASAI～IIlevel，theagefrom2to6yearsold，10to26kgweight，theywererandomlydividedintolaryngealmaskinhalationsevofluraneanesthesia(groupL)andendotrachealintubationinhalati

5、onsevoflurane(group，with20casesineachgroup．Anesthesiawasinducedbyinjectionpropofolandeisatracurium，andwasmain-tainedbyinhalationsevofluraneandinjectionremifentanil．Changeofthemeanarterypressure，heartrateduringintuba-tionanddrawingtubewererecorded．Bodymovement，nauseaandvomiting，resdessnesswerealso

6、recorded．ResultsTherewerenosignificantlychangesofHRandMAPrecordedbeforeandafterintubationingroupL'>0．05)．Com-paredwithgroupL，theHRandMAPrecordedafterintubationandextubationingroupTweresignificantlyhigher，andhigherincidenceofbodymovementinpostanestheticrevivalfP之O．05)．ConclusionLaryngealmaskinhala

7、tionsevoflu—raneanesthesiacombinedwithremifentanilhasadvantagesofsmootheranesthesiainbothinductionandrecoverytime，andrecoverywithlessadverseeffects．【Keywords】Laryngealmask；Children；Sevoflurane；Hypospadias；Remifentanil；