七氟烷与丙泊酚用于小儿唇腭裂手术诱导比较

目的 比较小儿麻醉用七氟烷吸入诱导和丙泊酚静脉诱导的临床特点。方法 择期手术的患儿30例，ASAI～Ⅱ级，随机分为两组：七氟烷（Sev）组和丙泊酚（Pro）组，分别记录诱导至意识消失的时间，和诱导前、诱导时、插管后即时和插管后1min的血压、心率、SpO2，及诱导时躁动、屏气、喉、支气管痉挛、恶心、呕吐等不良反应。结果 两组患儿意识消失的时间没有显著差异，分别为丙泊酚组（35．5±11．7）s；七氟烷组（38．5±11．4）s。两组诱导和插管后血压与诱导前比较均无明显变化，但心率变化两组相差较大，丙泊酚组与诱导前相比心率显著增加（P＜0．05），而七氟烷组心率较诱导前明显下降（P＜0．05）。发生躁动七氟烷组显著多于丙泊酚组（P＜0．05），分别是46％和20％。两组均未见屏气、喉及支气管痉挛和恶心、呕吐等不良反应。结论 两组在麻醉诱导的时间和有效性、安全性上没有差别，但是丙泊酚静脉诱导心率明显增快，七氟烷吸入诱导患儿躁动相对较多。

Comparison of Induction of Sevoflurane and Propofol in Pediatric of Cleft Lip and Palate Surgery

Objective To compare the induction characteristics of sevoflurane inhalation with intravenous propofol in pediatric surgery. Methods 30 children（ASA physical status I and II ） undergoing selective operations were randomly divided into two groups, received induction by inhalation of sevoflurane or intravenous of propofol, respectively. BP, HR and SPO2 were recorded before induction of anesthesia, after induction, immediately after and one minute after tracheal intubation. Time of consciousness loss, restlessness, breathholding, laryngospasm, bronchiospasm, nausea and vomiting were also recorded. Results The time of loss of consciousness in the group of propofol and group of sevoflurane were （35.5 ±11.7 ）s and （38.5 ± 11.4）s, respectively. There was no significant difference between the two groups. BPs after induction or tracheal intubation in both groups, compared with before induction, were no significant change. But the changes in HR were significantly different between two groups （P〈0.05 ）. Compared with before induction, HRs in group of propofol increased signiflcantly（P〈0.05 ）, And HRs in group of sevoflurane significantly decreased （P〈0.05 ）. Restlessness was more common during induction with sevoflurane than propofol （46% vs 20% ,P〈0.05 ）. No incidence of breathholding, laryngospasm, bronchiospasm, nausea and vomiting were noted in both groups. Conclusion Both propofol and sevoflurane can be used effectively and safely for induction of anesthesia in pediatric surgery. But heart rate increases during induction with propofol and excitatory movement is more common during induction with sevoflurane.