七氟烷复合瑞芬太尼在小儿麻醉中的临床应用

目的观察七氟烷用于小儿患者手术时的诱导和苏醒特征,以及复合瑞芬太尼在麻醉中的可行性和效果。方法 60例患儿(ASA1-2级),5%七氟烷吸入诱导,2%～3%七氟烷吸入和瑞芬太尼泵入维持,观察诱导反应、切皮反应、血压、心率、心电图、血氧饱和度、和呼吸情况及苏醒情况。结果诱导平稳,切皮反应轻,生命征稳定,呼吸平稳,苏醒快。结论七氟烷吸入诱导是小儿全麻一种有效且耐受性好的方法。七氟烷复合瑞芬太尼在小儿手术中的安全性高、麻醉深度容易掌控,是一种理想的麻醉方法。     

七氟烷吸入与丙泊酚-瑞芬太尼靶控输注在宫腔镜麻醉中的应用比较

目的对比观察单纯七氟烷吸入麻醉与靶控丙泊酚-瑞芬太尼麻醉用于妇科宫腔镜麻醉中的作用。方法择期手术患者80例,ASAⅠ～Ⅱ级,随机分为S组（七氟烷组）与TCI组（丙泊酚-瑞芬太尼组）。S组通过面罩以潮气量法吸入七氟烷,术中用2％～3％七氟烷和3L／min氧流量吸入维持麻醉。TCI组用双道TCI泵,靶控血浆浓度,术中以1％丙泊酚2．0μg／ml、瑞芬太尼1．0ng／ml血浆浓度TCI,两组术后即刻停止用药。监测患者围手术期的血压和心率,同时观察诱导入睡时间、术中呼吸情况、麻醉苏醒情况,并评定麻醉效果,观察麻醉恢复期相关并发症。结果TCI组入睡时间明显短于S组（P〈0．01）;术毕恢复时间、定向力恢复时间两组无明显差别。麻醉起效时两组患者MAP与术前比较均有明显下降（P〈0．01）;TCI组在扩宫颈时、宫腔操作时与S组比较,MAP有明显下降（P〈0．05）。TCI组术中麻醉效果优于S组（P〈0．01）,TCI组呼吸抑制发生率较S组高（P〈0．01）。两组术后均无恶心、呕吐及躁动等发生。结论TCI丙泊酚-瑞芬太尼麻醉较单纯七氟烷吸入麻醉效果更佳,而七氟烷麻醉更易维持循环系统和呼吸系统的稳定。TCI丙泊酚-瑞芬太尼麻醉可提供与单纯七氟烷吸入麻醉相当的快速苏醒。两种麻醉方法均可用于妇科宫腔镜麻醉。     

瑞芬太尼复合利多卡因在小儿气管异物取出术中的应用

目的观察瑞芬太尼复合利多卡因在小儿气管异物取出术中的应用效果。方法气管异物患儿40例,随机分为R组和F组,每组20例。均入室后吸入七氟醚,入睡后行静脉穿刺,静脉穿刺后停止吸入七氟醚。之后R组静脉注射1%利多卡因3mg.kg-1,静脉泵注异丙酚50～150μg.kg-1.min-1、瑞芬太尼0.1～0.5μg.kg-1.min-1和静脉注射维库溴铵0.05 mg.kg-1维持麻醉(R组,n=20);F组静脉穿刺后不注射利多卡因,而是静脉泵注异丙酚50～150μg.kg-1.min-1、静脉注射芬太尼2μg.kg-1和静脉注射维库溴铵0.05 mg.kg-1维持麻醉(F组,n=20)。术中经硬质支气管镜侧孔行高频通气。记录各时点血流动力学变化,对比两组患儿术中体动、屏气呛咳、低氧饱和度(SpO2降至90%以下)、硬质气管镜退镜次数以及术后呛咳、躁动发生率,并比较手术时间和苏醒时间。结果两组术中患儿术中体动、低氧饱和度、支气管镜退镜次数、手术时间和术后躁动无统计学差别,R组术中、术后呛咳发生率少、苏醒更加迅速、术中血流动力学更稳定。结论瑞芬太尼复合利多卡因在小儿气管异物取出术中的应用,术中术后并发症少,苏醒迅速且苏醒质量高。     

异丙酚复合瑞芬太尼麻醉在小儿气管支气管异物取出术中的应用

目的：探讨在小儿气管支气管异物取出术中异丙酚复合瑞芬太尼麻醉的应用。方法：收集于2011年4月～2013年4月入我院行气管支气管异物取出术的62例患儿的临床资料,对这些资料进行回顾性分析。按入院就诊时间将这些患儿分为观察组和对照组,每组包括患儿31例。观察组患儿采用的麻醉方法是异丙酚复合瑞芬太尼,对照组患儿采取的麻醉方法是异丙酚复合氯胺酮,比较两种麻醉及手术效果。结果：两组患儿术中最低SpO：观察组高于对照组;在并发症的发生率和手术之后患儿的苏醒时间方面,两组均差异显著,具有统计学意义（P〈0．05）。结论：在小儿气管支气管异物取出术中,异丙酚复合瑞芬太尼麻醉可控制性强,也比较安全,是一种良好的麻醉方法。     

七氟烷或丙泊酚复合瑞芬太尼的麻醉苏醒质量比较

目的比较七氟烷复合瑞芬太尼与丙泊酚复合瑞芬太尼维持麻醉术后患者的苏醒质量。方法ASAⅠ^Ⅱ级择期行乳突根治术患者60例,随机分为七氟烷复合瑞芬太尼组(S组)和丙泊酚复合瑞芬太尼组(P组),每组30例。两组麻醉诱导方式相同,且均予瑞芬太尼静脉泵注0.1Ⅱ级择期行乳突根治术患者60例,随机分为七氟烷复合瑞芬太尼组(S组)和丙泊酚复合瑞芬太尼组(P组),每组30例。两组麻醉诱导方式相同,且均予瑞芬太尼静脉泵注0.1⁰.15μg·kg-1·min-1。S组吸入七氟烷(浓度1.5%0.15μg·kg-1·min-1。S组吸入七氟烷(浓度1.5%².5%),手术结束前10 min停用七氟烷并加大氧流量至6 L·min-1;P组静脉泵注丙泊酚62.5%),手术结束前10 min停用七氟烷并加大氧流量至6 L·min-1;P组静脉泵注丙泊酚6⁸ mg·kg-1·h-1,手术结束前10 min停用。术毕观察并记录患者自主呼吸恢复时间、呼之睁眼时间、听从指令时间、拔管时间和定向力恢复时间,记录苏醒期躁动情况及术后恶心、呕吐发生率,评价拔管后30 min内镇静-觉醒(OAA/S)评分。结果与P组比较,S组自主呼吸恢复时间明显延长(P<0.05);呼之睁眼时间、听从指令时间、拔管时间和定向力恢复时间缩短(P<0.05)。两组间躁动发生率和术后恶心、呕吐发生率无显著差异(P>0.05)。拔管后两组患者OAA/S评分均逐渐增高,S组拔管即刻和拔管后10 min时的OAA/S评分高于P组(P<0.05),拔管后20、30 min时两组OAA/S评分无显著差异(P>0.05)。结论丙泊酚复合瑞芬太尼维持麻醉患者自主呼吸恢复快,但七氟烷复合瑞芬太尼患者拔管时间更早,苏醒更快、更彻底,苏醒质量较高。     

七氟醚复合瑞芬太尼在小儿气管异物取出术中的应用（附32例报告）

小儿气管异物是耳鼻喉科的危急症之一,常伴有不同程度的缺O2CO2蓄积及呼吸困难.     

七氟烷麻醉下小儿气管异物取出手术护理配合

作为新型的吸入全身麻醉剂,七氟烷具有无呼吸道刺激、麻醉诱导与苏醒迅速、对肝。肾功能影响小等优点,适用于患儿的全身麻醉。但在气管异物取出麻醉过程中由于吸入诱导会出现咳嗽、屏气等现象,进入麻醉期患儿可能出现不自主的肢体运动,如何使患儿安全地度过麻醉期,给护理人员提出了更高的要求,因此,手术室护士配合麻醉师对小儿气管异物取出的麻醉管理显得非常重要。     

无肌松药下瑞芬太尼、丙泊酚复合七氟烷在小儿腺样体、扁桃体切除术中的应用分析

目的观察不使用肌松药的情况下七氟烷复合瑞芬太尼、丙泊酚诱导气管插管的效果,对血流动力学的影响以及术后完全清醒的时间,评价其可行性。方法将60例ASAⅠ～Ⅱ级行腺样体、扁桃体择期手术的患者,随机分为两组,Ⅰ组在无肌松药下应用瑞芬太尼、丙泊酚复合七氟烷诱导插管,Ⅱ组应用瑞芬太尼、丙泊酚复合罗库溴铵诱导插管。分别记录两组患者各时点的HR和平均动脉压(MAP)。结果两组气管插管成功率均为100%,T0、T1时两组HR和MAP比较,差异均无统计学意义(P>0.05)。与T1比较,两组T2、T3、T4、T5的HR和MAP均显著下降(P<0.05)。术后Ⅰ组患者苏醒时间和拔管时间均少于Ⅱ组(P<0.05),Ⅰ组的不良事件发生率小于Ⅱ组(P<0.05)。结论无肌松药下七氟烷复合瑞芬太尼、丙泊酚应用在小儿腺样体、扁桃体切除术中,麻醉诱导平稳,能够提供满意的麻醉效果,值得推广。     

七氟烷吸入麻醉行小儿气管异物取出术120例临床分析

目的观察七氟烷吸入麻醉用于小儿气管异物取出术的麻醉效果。方法咽喉镜暴露声门,以1%地卡因进行咽喉、声门、气管内表面麻醉,面罩吸入氧及七氟烷混合气体（氧流量6～8L/min.七氟烷浓度8%）进行麻醉诱导,并观察手术时间、苏醒时间、术中喉痉挛和术后恶心、呕吐发生率。结果所有患儿均成功取出异物,术中均无发生呼吸衰竭及呼吸道梗阻等并发症,痊愈出院。结论七氟烷吸入麻醉用于小儿气管异物取出术,是一种更为安全、有效的麻醉方法。     

七氟醚联合异丙酚在小儿气管异物取出术中的应用

目的观察七氟醚联合异丙酚静吸复合全麻下行小儿气管异物取出术的麻醉效果。方法46例拟施气管异物取出术的患儿随机分为2组:七氟醚组(S组),羟丁酸钠组(R组)。观察支气管镜置镜条件满意度;记录麻醉至手术开始时间、手术时间及麻醉苏醒时间;观察各项生命指标的变化及并发症的情况。结果两组都能够达到良好的置入喉镜满意度;七氟醚组苏醒时间短且苏醒效果佳,与羟丁酸钠组比较,差异有统计学意义(P<0.05);两组均无明显的并发症发生。结论在急诊小儿气管异物取出术中应用七氟醚及异丙酚麻醉,可以达到良好的麻醉效果,是一种安全有效的麻醉方法。     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

目的观察七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果。方法选择符合美国麻醉学会制定的Ⅰ-Ⅱ级标准、年龄1—4岁、行气管异物取出术小儿60例,随机数字表法分为七氟醚组和氯胺酮组,每组30例。七氟醚组采用吸入七氟醚诱导麻醉,术中维持药物选用丙泊酚1．5mg／（kg·h）微泵持续注入。间断吸入七氟醚;氯胺酮组静脉注射咪达唑仑0．1mg／kg和氯胺酮1．5mg／kg诱导麻醉,术中麻醉深度不足时分次静脉注射氯胺酮1．5mg／kg至麻醉满意。记录诱导前（T0）、麻醉诱导后术前1min（T2）、插入支气管镜时（T2）、拔支气管镜时（T3）、清醒时（T4）血压、心率及血氧饱和度。记录手术时间、苏醒时间和术中医生满意度,观察术中和术后患儿是否有支气管痉挛、呕吐、呼吸道梗阻、舌后坠等并发症。结果2组患儿T2时收缩压、心率较T0时明显升高。七氟醚组患儿T1时收缩压、心率较T0时明显降低;2组患儿血氧饱和度T1-T4各时段均较T0时明显升高;七氟醚组患儿苏醒时间显著快于氯胺酮组;七氟醚组患儿医生满意度较氯胺酮组高;术后氯胺酮组患儿舌后坠发生率明显高于七氟醚组,差异有统计学意义（P〈0．05）。2组患儿T0～T4各时段舒张压、血氧饱和度差异均无统计学意义（P〉0．05）。结论七氟醚复合丙泊酚在小儿气道异物取出术中能提供良好的手术条件,术中麻醉平稳,术后患儿苏醒快且苏醒质量较高。     

瑞芬太尼与丙泊酚及琥珀胆碱复合全身麻醉并高频喷射通气在婴幼儿气管异物取出术中的应用

目的 探讨瑞芬太尼与丙泊酚复合琥珀胆碱全身麻醉并高频喷射通气(HFJV)在婴幼儿气管异物取出术的效果及安全性.方法 30例行气管异物取出术的患儿完全随机分为研究组和对照组,每组15例.研究组静脉注射丙泊酚、瑞芬太尼和琥珀胆碱,插入支气管镜后经侧孔FHJV.对照组静脉注射氯胺酮、γ-羟丁酸钠和丙泊酚复合麻醉,保留自主呼吸,插入支气管镜后经侧孔吸纯氧或必要时HFJV.术中连续监测心电图、心率、呼吸和脉搏血氧饱和度(SpO2),比较2组患儿术中各生命体征变化及发生呛咳、屏气、呼吸暂停、支气管痉挛的次数,手术时间、苏醒时间苏醒期并发症.结果 2组患儿年龄、性别、体重、术前SpO2差异无统计学意义(P＞0.05).2组患儿的HR置镜前[研究组和对照组分别为(105±4)次/min和(110±6)次/min]较诱导前[研究组和对照组分别为(142±6)次/min和(140±4)次/min]均有明显下降(P＜0.05),其余各时点变化差异均无统计学意义(P＞0.05).研究组发生低氧血症5例、心动过缓1例;对照组发生低氧血症25例、呛咳屏气8例、喉支气管痉挛5例、心动过缓4例.对照组不良反应发生率高于研究组,差异有统计学意义(P＜0.05).研究组平均手术时间(10.9±4.1)min,苏醒时间(30.5±9.2)min;对照组平均手术时间(19.9±5.0)min,苏醒时间(60.2±15.6)min.2组手术及苏醒时间差异具有统计学意义(P＜0.05).研究组苏醒期发生恶心呕吐2例、躁动1例;对照组发生恶心呕吐7例,躁动4例,喉、支气管痉挛5例.2组患儿恶心呕吐及喉、支气管痉挛的发生率差异有统计学意义(P＜0.05).结论 在婴幼儿气管异物取出术中,采用瑞芬太尼、丙泊酚复合琥珀胆碱全身麻醉加用HFJV较传统的氯胺酮复合γ-羟丁酸钠保留自主呼吸麻醉能更好地维持患儿呼吸、循环稳定,缩短手术时间,是一种安全、有效的麻醉方法.

Abstract：

Objective To discuss the effect and safety of surgery of removing foreign body in trachea of infants by using remifentanil, propofol and succinylcholine anesthesia combined with high-frequency jet ventilation (HFJV). Methods Totally 30 infants receiving surgery of removing foreign body in trachea were divided into two groups randomly: study group (propofol, remifentanil and succinylcholine) and control group. Each group has 15 patients. Patients of study group were given intravenous injection of propofol, remifentanil and succinylcholine and eliminated spontaneous breathing. After inserting bronchoscope, HFJV through the side hole was applied. Patients of control group were given intravenous injection of Ⅳ ketamine, γ-sodium hydroxybutyrate, propofol anesthesia and spontaneous breathing was reserved. After bronchoscope insertion, patients absorbed the pure oxygen through the side hole. They were given HFJV when necessary. During the operation, electrocardiogram (ECG), heart rate (HR) , respiratory (RR) and pulse oxygen saturation(SpO2) were continuously monitored, and compared various changes of vital sign, the times of patient choking, breath holding, apnea, and bronchospasm, and operation time, recovery time and complications during the recovery period. Results The adverse reaction and complications during the recovery period of study group were significantly lower than those in control group(P ＜0.05). Moreover, surgery and recovery time were significantly shorter than those in control group(P＜0.05). Conclusion During the surgery of removing foreign body in trachea of infants, the propofol, remifentanil and succinylcholine anesthesia combined with HFJV is superior to the traditional anesthesia in terms of keeping spontaneous breathing in maintaining stable respiration and circulation and reducing operation time.     

七氟醚、丙泊酚联合瑞芬太尼在腹腔镜子宫肌瘤切除术中的应用

目的探析对比不同静吸复合麻醉用药策略在腹腔镜子宫肌瘤切除术(LM)中的临床效果。方法选择南阳医学高等专科学校第一附属医院2020年6月至2022年3月收治的127例LM患者作为研究对象, 根据手术麻醉方案的不同将患者分为观察组[64例, 年龄(43.47±5.28)岁]和对照组[63例, 年龄(43.59±5.14)岁]。两组实施不同静吸复合用药策略, 对照组给予丙泊酚+瑞芬太尼, 观察组给予七氟醚+瑞芬太尼。对比两组麻醉安全性指标, 麻醉前、术后10 min血流动力学指标[心率(HR)、平均动脉压(MAP)]及应激反应相关指标[去甲肾上腺素(NA)、血清皮质醇(COR)], 围麻醉期不良反应风险。计量资料比较采用t检验, 计数资料采用χ2检验。结果麻醉前两组MMSE评分分别为观察组(28.73±0.25)分比对照组(28.69±0.28)分, 差异无统计学意义(t=0.850, P=0.397);术后1 d两组MMSE评分分别为观察组(28.02±0.24)分比对照组(27.11±0.22)分, 差异有统计学意义(t=22.264, P<0.001)。观察组瑞芬太尼用药剂量为(...     

小儿气管异物取出术的麻醉处理

目的 探讨小儿气管异物取出术有效的麻醉处理方法.方法 选取本院60例行气管异物取出术患儿为研究对象,随机分成两组,A组(30例)采取七氟醚吸入诱导,B组(30例)采取丙泊酚静脉注射诱导,术中靶控输注丙泊酚和瑞芬太尼维持,比较两组的麻醉效果.结果 两组均顺利手术,两组麻醉诱导后、插入气管镜后、清醒后的MAP、HR均有改变,组间插镜后的MAP、HR比较差异均有统计学意义;A组手术时间、气管镜出入次数、麻醉恢复时间均明显少于对照组,A组不良反应发生率为16.7％,B组不良反应发生率为73.3％,两组比较差异有统计学意义.结论 相较于丙泊酚,七氟醚吸入诱导在小儿气管异物取出术中的麻醉效果更佳,不良反应更少,值得临床应用.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟烷或丙泊酚联合瑞芬太尼用于全身麻醉的效果比较

目的比较七氟烷复合瑞芬太尼与丙泊酚复合瑞芬太尼两种全身麻醉维持方式在甲状腺手术中的应用效果。方法择期行甲状腺手术的患者60例,随机分为S组和P组各30例。在同样经喉罩全身麻醉并在听觉诱发电位指数（AAI）监测指导下,麻醉维持P组采用靶控输注丙泊酚（靶浓度2．5～3．5mg／L）联合瑞芬太尼（靶浓度4．5-5．5μg/L）效应室靶控输注（TCI）;S组采用吸入七氟烷（2％-4％）联合瑞芬太尼（靶浓度2．5～4．0斗s／L）。记录入室后诱导前（T0）、麻醉诱导后插喉罩前（T1）、插入喉罩时（T2）、切皮时（L3）、游离甲状腺时（T4）、切除甲状腺或肿物时（L5）、拔除喉罩时（T6）和出手术室时（L7）等8个时段的HR、SBP、DBP,停止麻醉至拔除喉罩的时间、拔除喉罩时的清醒程度和术后并发症情况。结果两组HR、SBP、DBP比较,T0、T1、T2、L3等四个时点的差异均无统计学意义（均P〉0,05）;T4、L5、T6、L7等四个时点的差异均有统计学意义（均P〈0．05）。两组问拔除喉罩时间及拔喉罩时清醒程度差异均无统计学意义（均P〉0．05）。术后并发症方面比较,S组苏醒期躁动、头晕嗜睡、寒战和出室时伤口疼痛的发生率较低（均P〈0．05）,两组均未发生恶心呕吐。结论七氟烷复合瑞芬太尼麻醉方式更佳,术中血流动力学更稳定,术后并发症发生率更低。