七氟烷在门诊小儿胃镜检查中的应用

目的 观察七氟烷用于门诊小儿胃镜检查的临床效果.方法 60例ASAⅠ～Ⅱ级行包皮环切手术的门诊患儿,年龄3～7岁,随机分为A、B两组.A组患儿给予浓度8%七氟烷面罩吸入诱导,患儿入睡后开放静脉,术中通过加压面罩吸入3%～5%七氟烷维持麻醉.B组患儿首先开放静脉通道,给予丙泊酚2mg/kg,术中采用微量注射泵给予丙泊酚0.5～1ml/kg·h持续输注,同时鼻导管给氧.所有患儿监测并记录诱导前(T0)、诱导后5min(T1)、手术开始时(T2)、手术结束时(T3)、手术结束后5min(T4)、手术结束后15min(T5)时的SPO2、HR和MAP.所有数据采用SPSS13.0软件包进行统计学分析.结果 B组出现T2～T5时段的MAP升高,HR增快(P<0.01);A组T1～T5时段MAP、HR水平稍增加,没有显著性差异(P>0.05).术后停药到苏醒的时间,B组＞A组,有显著性差异(P<0.01).A、B两组患者术后躁动和恶心呕吐发生率无显著性差异,呼吸抑制两组均未发生.结论 七氟烷用于门诊小儿胃镜检查具有术后苏醒过程平稳、舒适,不良反应少的优点.     

高浓度七氟烷全凭吸入麻醉用于小儿肛肠手术的临床价值

目的对高浓度七氟烷全凭吸入麻醉用于小儿肛肠手术的临床价值进行研究分析。方法将近两年在我院接受肛肠手术治疗的80例小儿患者随机分为观察组(七氟烷全凭吸入麻醉)与参考组(氯胺酮肌肉注射基础麻醉)各为40例，分别观察两组患儿术中体征情况、麻醉效果及麻醉后并发症发生情况等。结果观察组患儿麻醉后不同时间段心率、舒张压、收缩压水平均明显优于参考组(P<0.05)；观察组患儿术后苏醒时间、睁眼时间与参考组比较均明显较短(P<0.05)，观察组患儿术后并发症发生率显著低于参考组(P<0.05)。结论在小二肛肠手术中使用高浓度七氟烷全凭吸入麻醉可减少对患儿血流动力学的稳定，患儿可较快苏醒，安全性高。     

小儿七氟烷吸入麻醉苏醒期躁动处理进展

七氟烷麻醉诱导迅速、苏醒快、麻醉维持平稳、对呼吸循环影响小,目前已经广泛应用于小儿手术麻醉,但是临床观察发现小儿七氟烷吸入麻醉术后躁动的发生率较高,其机制尚不完全清楚。目前临床处理小儿吸入麻醉苏醒期躁动的方法很多,本文结合近期相关的文献,综述小儿七氟烷术后躁动的机制及其目前的处理方法。     

喉罩联合七氟醚吸入麻醉在小儿舌系带矫正术中的 临床应用

目的 探讨喉罩联合七氟醚吸入麻醉应用于小儿舌系带矫正术中的临床应用效果和安全性。方法 择期行舌系带矫正术小儿60例,分为气管插管组（T组）和喉罩组（L组）两组,每组30例。8%七氟醚+5 L/min氧气诱导,开放外周静脉,静脉注射芬太尼1 μg/kg,罗库溴铵0.3 mg/kg。待脑电双频指数（BIS）达45~50时,T组插入气管导管,L组置入喉罩并在口腔两侧放入纱布,术中调整1.5%~3%七氟醚和2 L/min氧气,维持BIS 40~60。分别记录麻醉前（T1）、置管/喉罩即刻（T2）、手术开始时（T3）、拔管/喉罩即刻（T4）的SBP、HR、ETCO2和SpO2,手术时间、诱导时间、苏醒时间以及患儿术后呛咳、喉痉挛、反流误吸及苏醒期躁动等不良反应的发生情况。结果 两组患儿均没有出现反流误吸。T组术后呛咳8例,苏醒期躁动9例,喉痉挛1例,而L组术后呛咳1例,苏醒期躁动2例,喉痉挛未出现。与T组相比,L组术后呛咳和苏醒期躁动病例数减少,差异具有统计学意义（P＜0.05）。与T1比较,T组在T2、T4时点SBP、HR增高,差异有统计学意义（P＜0.05）。与L组相比,T组苏醒时间延长,差异有统计学意义（P＜0.05）。结论 喉罩联合七氟醚吸入麻醉可安全应用于小儿舌系带矫正术,对小儿呼吸道刺激小,并发症少。     

七氟醚吸入诱导插管在小儿心脏手术中的应用

本文总结在吸入高浓度七氟醚在小儿先心病麻醉诱导插管中的应用。1临床资料先天性心脏病患儿47例(其中有紫绀型6例,肺动脉高压17例)心功能Ⅰ～Ⅱ级,年龄从18个月到16岁,体重从9.5kg到55kg,术前常规给予哌替啶1mg/kg,阿托品0.01mg/kg,面罩吸入氧5～6L/min 8%七氟醚诱导。待疼痛反射消失     

七氟烷联合TOF监测在面神经微血管减压术中的应用

目的 探讨面神经微血管减压术中七氟烷联合神经电生理四个成串刺激(TOF)监测的麻醉方案。方法 纳入我院行微血管减压手术的77例面肌痉挛患者,依据七氟烷的使用情况将患者分为3组：A组全程使用七氟烷(n=25),B组不使用七氟烷(n=22),C组当TOF值≥50%后联合使用七氟烷(n=30)。比较各组血流动力学变化和体动、呛咳情况,记录各组患者TOF值恢复所需要的时间,及患者切开硬脑膜前侧方扩散反应(LSR)引出率和波幅。探讨TOF值与LSR波幅的关系。结果 A组、C组患者术中均未出现体动及呛咳,B组中2例患者出现轻微体动。各组T1～T6时的心率和收缩压比较,均无显著性差异(P>0.05);B组的心率、收缩压变异系数与A组、C组比较均有显著性差异(P<0.001)。B组、C组TOF值恢复时间较A组短(P<0.001);B组、C组最早引出LSR所需时间较A组短(P<0.05)。LSR平均波幅随TOF值的恢复逐渐增高(P<0.001),当TOF值达到80%～89%后波幅增加不显著(P>0.05);B组、C组所有患者能在切开硬脑膜前建立LSR监测的准确基线,而...     

七氟醚吸入麻醉在小儿短小手术的应用

小儿短小手术通常在门诊进行,如何使麻醉既安全又便捷,且能减少并发症的发生,是值得临床研究的课题.为此,我院尝试在小儿短小手术中应用七氟醚吸入麻醉,取得了较为满意的效果,现介绍如下.     

七氟醚在小儿麻醉诱导中的临床应用

目的通过研究七氟醚在对小儿麻醉中的相关诱导作用,总结临床经验。方法对我院2011年5月~2012年5月收治的全麻下行手术患儿进行观察研究,将患儿分为对照组和观察组,对照组患儿采用氯胺酮进行静脉麻醉,而观察组采用七氟醚吸入麻醉,对患儿的呼吸和心率进行观察总结,并记录停药之后患儿的疼痛持续时长等项目。结果在进行对比后发现,对照组患儿的分泌物增加、术后呕吐等数量远远高于观察组患儿,差异具有显著性（P＜0.05）。结论采用七氟醚对患儿进行麻醉,效果较好、麻醉速度快、没有刺激性味道,不太影响患儿的循环呼吸且术后苏醒快,是应该推广使用的临床方法。     

七氟烷预处理抑制缺氧诱导的脑损伤

目的:观察七氟烷预处理对缺氧小鼠脑损伤的影响及其可能机制。方法:将60只雄性C57BL/6J小鼠,随机分为对照(C)组、缺氧(H)组、2%七氟烷预处理30 min组(S1+H组)、2%七氟烷预处理60 min组(S2+H组)和4%七氟烷预处理30 min组(S3+H组),每组10只。缺氧即持续吸入O2体积分数为(6.5±0.1)%的氮氧混合气体24 h构建缺氧模型;预处理即以O2体积分数为(21.0±0.5)%的氮氧混合气体为载气,分别吸入2%七氟烷30 min、2%七氟烷60 min和4%七氟烷30 min,洗脱15 min后进行缺氧处理。用光学显微镜及透射电子显微镜(TEM)观察海马CA1区形态学改变;比色法检测血清乳酸脱氢酶(LDH)活性;ELISA测定脑组织促红细胞生成素(EPO)和血管内皮生长因子(VEGF)含量;同时测定脑组织丙二醛(MDA)含量及超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GPx)活性。结果:缺氧24 h后,光镜下可见海马CA1区细胞水肿或固缩;各预处理组病理改变轻于H组。TEM下S2+H组细胞超微结构最为完整。H组血清LDH活性及脑组织EPO、VEGF、MDA含量显著高于C组,脑组织的SOD及GPx活性较C组明显降低。七氟烷预处理后血清LDH活性及脑组织EPO、VEGF含量较H组降低,以S2+H组最为显著;脑组织MDA含量及SOD活性降低,而GPx活性有所升高。结论:七氟烷预处理能减轻缺氧引起的脑组织损伤,其机制可能与调节抗缺氧蛋白合成及降低氧化应激有关。     

丙泊酚与七氟烷用于无痛人流术的疗效观察

目的 评价丙泊酚与七氟烷用于无痛人流术的疗效.方法 选择拟行无痛人流术患者80例,随机分为丙泊酚组(P组)和七氟烷组(S组)各40例.P组静注丙泊酚3mg/kg,,给药速度10 mg/s;S组面罩紧闭吸入8%七氟烷.结果 循环稳定性比较S组优于P组;呼吸抑制和呛咳反射发生率P组较S组高;Aldrete改良评分麻醉后恢复总分≥9时所需时间S组明显少于P组;麻醉后满意度P组优于S组.结论 丙泊酚接受度更好,苏醒愉悦感更强;七氟烷术中更平稳,术后苏醒更完全.     

全凭吸入七氟醚麻醉在小儿腭裂修补术中的应用

目的：探讨全凭吸入七氟醚麻醉用于小儿腭裂修补术的效果及安全性。方法：40例择期腭裂修补术患儿随机均分为七氟醚组（S组）和安氟醚组（E组），每组20例。E组安氟醚浓度由1％逐渐升至4％，S组七氟醚浓度由1％逐渐升至8％。维持阶段，挥发性麻醉药浓度维持在1．3～1．5MAC。连续监测血压、心率等指标，观察并比较两组诱导、维持及恢复过程。结果：麻醉期间两组血压、心率比较无显著差异（P〉0．05），诱导及恢复过程拒吸、呛咳、躁动等各项指标S组明显好于E组（P〈0．05或P〈0．01）。结论：全凭吸入七氟醚麻醉是小儿腭裂修补术较理想的麻醉方法。     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

目的比较不同呼气末含量七氟烷对开颅手术癫痫及非癫痫患者皮层脑电图的影响。以探讨七氟烷是否适合癫痫手术过程中麻醉的维持,并且确定其最佳麻醉维持剂量。方法24例癫痫患者和15例非癫痫需要开颅手术患者常规麻醉后,切开硬膜后置入皮层电极,分别控制呼气末七氟烷含量0．7,1．0,1．3,1．5MAC,稳定15min后记录皮层脑电图,记录并分析棘波和其它脑波变化。结果癫痫组患者在1．0,1．3MAC七氟烷含量时,棘波数量和导联数与0．7MAC时无明显变化,而1．5MAC棘波频数和导联数明显高于0．7MAC时（P〈0．05）。非癫痫组患者在0．7,1．0,1．3MAC时均无棘波出现,在1．5MAC部分病例出现棘波,且导联弥散。随着七氟烷含量的增加,患者其它脑电波形变化相似,α和β波频率减少,δ波频率增加,而θ波频率变化不明显。结论癫痫患者手术时,如果进行皮层脑电监测,七氟烷含量控制在低于1．3MAC为宜。如果术中脑电监测时,无论是否癫痫患者,七氟烷含量大于1．5MAC均可能影响监测结果。     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.