【摘要】 目的探究七氟醚联合丙泊酚维持麻醉用于小儿鼻内镜手术中的效果。方法选取我院2016年1月-2017年7月期间收治的行鼻内镜下腺样体摘除的鼾症患儿44例进行前瞻性研究,随机将其分为两组,均予以阿托品溶液+咪达唑溶液静脉注射,丙泊酚+芬太尼+维库溴铵行麻醉诱导,22例予以七氟醚吸入维持麻醉(对照组),22例予以七氟醚吸入+丙泊酚泵入维持麻醉(观察组)。观察两组患儿意识消失时间、气管插管时间、麻醉后苏醒期基本情况(苏醒期呼吸恢复时间、咽喉反射恢复时间、睁眼时间和拔管时间)、拔管后不同时间点疼痛情况及术后并发症情况。结果观察组患儿意识消失时间及气管插管时间均明显较对照组短,组间差异显著(P<0.05);观察组患儿意识消失时间较对照组提前,组间差异显著(P<0.05),气管插管时间较对照组短,组间统计差异显著(P<0.05)。两组拔管后5 min、1 h、3 h及24 h患儿VAS评分均未见统计学差异(P>0.05)。观察组躁动及呛咳发生率明显低于对照组,且观察组躁动评分明显低于对照组,组间差异均显著(P<0.05)。结论七氟醚联合丙泊酚用于小儿鼻内镜手术维持麻醉,可促进患儿意识消失,还可降低患儿躁动、呛咳发生率。更多还原

【Abstract】 Objective To explore the effect of sevoflurane combined with propofol in anesthesia maintenance during pediatric endoscopic sinus surgery. Methods Forty-four cases of snoring children with endoscopic enucleation of adenoids treated in our hospital between January 2016 and July 2017 were selected for prospective study and randomly divided into two groups,both of which were treated with atropine solution 0.01 mg/kg+ midazolam 0.1 mg/kg solution for intravenous injection,and 2.5 mg/kg propofol+0.5 g/kg sufentanil+0.1 mg/kg vecuronium bromide for anesthesia induction. Half of these cases received sevoflurane inhalation for anesthesia maintenance( the control group),while the rest were subjected to the sevoflurane inhalation + propofol pump for anesthesia maintenance( the observation group). The time of loss of consciousness,intubation time,recovery,pain at different time points after extubation,and postoperative complications were observed. Results The time of loss of consciousness and tracheal intubation time in the observation group were significantly shorter than those of the control group( P<0.05). Loss of consciousness occurred earlier in the observation group than in the control group,and there was significant difference between the two groups( P<0.05). The inter group tracheal intubation time was shorter than that of the control group,and the difference was significant( P<0.05). At 5 min,1 h,3 h and 24 h after extubation,VAS scores showed no statistically significant difference between the two groups( P>0.05). The incidence of restlessness and cough in the observation group was significantly higher than that in the control group( P<0.05),but the restlessness score of the observation group was obviously lower than that of the control group,and the difference was remarkable( P<0.05).Conclusion Sevoflurane combined with propofol for anesthesia maintenance during pediatric endoscopic sinus surgery can not only promote the loss of consciousness in children,but also reduce the incidence of agitation and cough.更多还原