【摘要】 目的:观察等效剂量地佐辛或芬太尼在七氟醚全凭吸入麻醉下小儿疝气手术的临床疗效。方法:60例择期行小儿双侧疝气手术患儿,年龄3-5岁,体重13-20 kg,ASA I级,随机分为地佐辛组(D组)和芬太尼组(F组)(n=30),均实施七氟醚全凭吸入麻醉,保留自主呼吸。在插喉罩前5min分别静脉注射地佐辛0.1mg/kg(D组)、芬太尼2μg/kg(F组)。观察两组患儿诱导前(T0)、插喉罩前1min(T1)、插喉罩后即刻(T2)、插喉罩后5min(T3)和拔喉罩后1min(T4)、5min(T5)、15min(T6)的HR、MAP、SpO2、ETCO2、潮气量(VT)、呼吸频率(RR)变化及术后苏醒情况。结果:两组患儿的手术时间、麻醉时间、HR、MAP、SpO2等组间比较无统计学差异(P>0.05)。与T0比较,D组T3-T5ETCO2增高,T1、T3RR减少(P<0.05),F组T2-T5ETCO2增高,T1-T4RR减少(P<0.05);与F组比较,D组T3-T5ETCO2较低(P<0.05),术后苏醒时间较长,镇静满意率较高,术后躁动发生率较低(P<0.05)。结论:地佐辛复合七氟醚可安全用于小儿疝气手术的麻醉,较芬太尼能降低术后不良反应的发生率。更多还原

【Abstract】 Objective: To detect the clinical efficacy of equivalent dose of dezocine or fentanyl combined sevoflurane volatile induction and maintenance anesthesia during child hernial operation. Methods: 60 elective operation children patients aged 3- 5 years,weighted 13- 20 kg,ASA I were selected and randomly divided into 2 groups with 30 in each,the dezocine group( group D) and the fentanyl group( group F). The 2 groups adopted sevoflurance volatile general anesthesia under spontaneous respiration. Dezocine 0. 1 mg /kg( group D) and fentanyl 2. 0 μg /kg( group F) were givrn with intravenous injection before 5 min of inserting laryngeat mask. Heart rate( HR) 、mean arterial pressure( MAP) 、pulse oxygen saturation( SpO2) 、end tidal carbon dioxide patial pressure( ETCO2) 、tidal volume( VT) 、respiratory rate( RR) and situation of recovery period were recorded before induction( T0),1 min before inserting laryngeat mask( T1),immediately( T2) 、5 min( T3) after inserting laryngeat mask and 1 min( T4) 、5 min( T5) 、15 min( T6) after pulting laryngeat mask. Results: No significant difference was found between the 2 groups in operation time,anesthetic time,HR、MAP、SpO2( P >0.05). Compared with at T0,the levels of ETCO2at T3- T5were increased and RR at T1、T3were decreased significantly in group D( P < 0. 05),the levels of ETCO2at T2- T5were increased and RR at T1- T4were decreased significantly in group F( P < 0. 05); Compared with group F,the ETCO2levels at T3- T5were lower,the wake- up time was longer and the incidence of agitation at recovery period was lower in groep D( P < 0. 05). Conclusions: Dezocine combined sevoflurane was safty during child hernial operation and it could relieve the incidence of adverse effect post- operation compared with fentanyl.更多还原