丙泊酚靶控复合吸入低浓度异氟烷在小儿短小手术中的应用

    Propofol target controlled infusion combined with low-density isoflurane in preschool child

    • 摘要: 目的: 观察丙泊酚靶控复合吸入低浓度异氟烷用于小儿短小手术的麻醉效果。方法: 选择行择期腹股沟斜疝手术的患儿48例,随机分为氯胺酮麻醉组(A组)、丙泊酚靶控麻醉组(B组)和丙泊酚靶控复合低浓度异氟烷麻醉组(C组),每组16例。记录3组患儿在入室前(T0)、切皮时(T1)及缝皮时(T2)的HR、RR及SpO2,以及在切皮和牵拉疝囊时的麻醉效果评级和从术终至清醒时间。结果: 与T0相比,A组HR、RR在T1、T2时升高(P<0.05~P<0.01),而SpO2变化不大(P>0.05);与T0相比,B组的RR在T1时明显升高(P<0.01),但HR、RR和SpO2在T2时却比A组有所下降(P<0.05~P<0.01);C组的HR、RR在T1、T2及T3时均低于A组(P<0.05~P<0.01),与B组相比也有下降(P<0.05~P<0.01),但SpO2却较A组有所降低(P<0.01),但在吸氧情况下3组患儿的SpO2平均大于98%。结论: 丙泊酚靶控输注复合吸入低浓度异氟烷用于小儿短小手术不插管全麻是安全的,生命体征较平稳,麻醉效果满意,清醒较快。

       

      Abstract: Objective: To explore the effects of the target controlled infusion(TCI) for propofol combined with low density isoflurane in children undergoing minor operation.Methods: Forty-eight ASA grade Ⅰ-Ⅱchildren aged 2-6 yr weighting 11.5-25 kg,scheduled for hernia surgery were randomly divided into three groups with 16 cases in each:Ketamine group(group A),propofol TCI group(group B),and propofol TCI combined with low density isoflurane group(group C).The children in group A were given only Ketamine during operation.Heart rate(HR),respiration rate(RR) and pulse oxygen saturation(SpO2) were recorded before induction(T0),skin incision(T1),dragging peritoneum(T2) and sewing skin(T3).All children's reaction at the time of skin incision and dragging peritoneum was recorded.Results: Compared with T0,HR and RR at T1,T2 in group A significantly rised(P<0.05-P<0.01),but the variation of SpO2 was not significant(P>0.05).In group B,compared with T0,RR significantly rised at T1(P<0.01),but HR,RR and SpO2 declined at T2 compared that of in group A(P<0.05).In group C,HR and RR decreased significantly at T1,T2 and T3 compared with those in group Aand group B(P<0.05-P<0.01) and SpO2 declined at the same time compared with group A(P<0.05).The children' SpO2 in the three groups all exceeded 98% with oxygen inhaling.The time of regaining consciousness in group C reduced significantly compared with that in group A and group B(P<0.05).Conclusions: Propofol TCI combined with low density isoflurane in preschool chileren who accepted general anesthesia is safe and satisfied with the life sign stableness and a short revival time.

       

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