【摘要】 目的 探讨七氟烷吸入麻醉应用于小儿心脏彩色多普勒超声检查时的最佳维持浓度。方法 35天～3岁患儿120例,排除严重紫绀型先天性心脏病及严重肺炎患儿,按美国医师学会(ASA)分级Ⅰ～Ⅱ级,所有患儿均在七氟烷吸入麻醉下行心脏彩色多普勒超声检查。按照七氟烷吸入浓度分为1.0%、1.5%、2.0%、2.5%4个浓度组,每组30例。记录各组诱导时间、检查时间、苏醒时间,监测患儿血压、心率、呼吸和脉搏氧饱和度的变化。同时记录各组患儿麻醉镇静过程中Ramsay评分情况以及无法完成检查的例数。结果 1.0%七氟烷吸入浓度维持麻醉时,患儿Ramsay评分较低,与其他各组比较P <0.05,检查过程中有8例患儿无法配合。当七氟烷吸入浓度增加时,Ramsay评分也增加。当七氟烷吸入浓度达到1.5%时,患儿能安静入睡,检查过程中无躁动现象,血压平稳。七氟烷吸入浓度增加至2.5%时,患儿Ramsay评分没有继续增加,但苏醒时间明显延长(P<0.05)。各组患儿血压、心率呼吸和脉搏氧饱和度无明显异常变化。结论 在保证安全及有效的情况下,七氟烷吸入麻醉用于35天～3岁小儿心脏彩色多普勒超声检查时的最佳浓度为1.5%～2.0%。更多还原

【Abstract】 Objective To investigate the optimal concentration of sevoflurane inhalation anesthesia for color Doppler echocardiography in young children.Methods 120 pediatric patients aged 35 days to 3 years with an American Society of Anesthesiology(ASA) physical status Ⅰ or Ⅱ without severe cyanotic heart disease or pneumonia were recruited in this study.All the subject received sevoflurane inhalation anesthesia for color Doppler echocardiography.According to the the inspired concentration of sevoflurane,the children were assigned to 4 groups(1.0%,1.5%,2.0%,and 2.5%,n=30 each).Induction time and post-anesthesia awareness time were recorded.The Ramsay sedation score,blood pressure,heart rate,respiration,and pulse oximetry were recorded during the examination.Results Compared with the other three groups,the Ramsay sedation score decreased at 1.0% sevoflurane(P <0.05) and there were 8 children who did not finish the examination.The Ramsay sedation score increased when the concentration of sevoflorane increased.When the concentration of sevoflorane reached 1.5%,the children could go to sleep peacefully without restlessness and the blood pressure remained steady during the examination.When the concentration of sevoflorane was increased to2.5%,the Ramsay sedation score did not increase,while the post-anesthesia awareness time was significanly longer(P<0.05).No abnormal changes of the blood pressure,heart rate,respiration,and pulse oximetry were observed during the esmamination in all groups.Conclusion To ensure the safety and effecacy,the optimal sevoflurane concentration for echocardiography in children between the age of 35 days and 3 years is 1.5%-2.0%.更多还原