七氟烷吸入麻醉在儿童喉手术中的应用观察

目的探讨七氟烷吸入麻醉在儿童喉手术中的应用效果。方法将80例喉手术患儿,随机分为观察组和对照组两组,每组各40例。对照组给予患儿氯胺酮静脉麻醉治疗,观察组给予患儿七氟烷吸入麻醉治疗,对两组患儿的麻醉效果进行对比。结果两组患儿麻醉前平均动脉压、心率比较,差异无统计学意义(P0.05),但术前、术后10、30 min及手术结束时观察组明显优于对照组,观察组患者的麻醉诱导时间、苏醒时间、镇痛评分等均明显优于对照组,两组对比差异均有统计学意义(P0.05)。结论给予喉手术患儿七氟烷吸入麻醉治疗可取得良好麻醉效果,且术后镇痛作用好,效果肯定。     

氟烷吸入麻醉在唇腭裂修补术中的应用

氟烷吸入麻醉在唇腭裂修补术中的应用程明华＊由“国际微笑行动组织”发起并组织的美国医疗队在我院实施唇腭裂修补术１８７例，全部采用氟烷吸入诱导并维持的气管内全身麻醉，取得良好效果。临床资料唇裂修补术５３例、腭裂修补术８３例、唇腭裂联合修补术５１例。１岁以...     

异氟烷与七氟烷用于腹部手术闭环靶控吸入麻醉的对照研究

目的:比较在腹部手术闭环靶控吸入麻醉中,七氟烷与异氟烷在脑电双频指数(BIS)波动、血液动力学稳定性、辅助药物应用、苏醒情况与术中知晓等方面的差异。方法:40例择期腹部手术的患者分为七氟烷组(25例)与异氟烷组(15例)。两组均采用经静脉诱导、吸入麻醉药闭环靶控系统维持麻醉;采用BIS为反馈控制变量,并设定BIS值55为控制目标。记录并比较两组的BIS值、血压、心率、辅助药物剂量、苏醒时间、苏醒期躁动和术中知晓等数据。结果:两种药物对麻醉全程的BIS、HR、和脉压差比较差异无统计学意义,但在术中七氟烷组BIS波动与收缩压波动显著小于异氟烷组(P<0.05)。七氟烷组睁眼时间显著少于异氟烷组(P<0.01);两组躁动发生差异无统计学意义。但两组亚宁定与麻黄碱用量比较无统计学显著性差异。两组病人均无术中知晓发生。结论:在腹部手术闭环靶控吸入麻醉中,七氟烷与异氟烷相比,可减少术中的BIS和收缩压的波动,缩短患者的睁眼时间。     

七氟醚和氟烷在小儿唇腭裂手术麻醉中应用的比较

我院自1996年以来在国际微笑行动中采用Jacson Rees回路吸入氟烷或七氟醚的全身麻醉下对唇腭裂患儿行唇腭裂修补术,现报道如下。资料与方法一般资料ASAⅠ级唇腭裂手术患儿100例,男58例,女42例,年龄6月~8岁,体重6~25kg。随机分为氟烷组和七氟醚组,每组50例,分别吸入氟烷和七氟醚     

小儿腭裂修复手术麻醉体会

小儿腭裂修复手术麻醉体会温小红＊黄素琴＊陈庆廉＊我院自１９８４～１９９６年间共收治１４岁以下小儿腭裂２３３例，现将麻醉处理的体会报告如下。资料与方法本组２３３例，男１４２例，女９１例，年龄１６月～１４岁，体重６～４０ｋｇ，其中３岁以下２４例，４～９岁...     

七氟烷吸入麻醉在小儿短小手术中的应用效果观察

目的观察小儿短小手术中应用七氟烷吸入麻醉的效果。方法将40例择期行短小手术小儿随机分为七氟烷组和氯胺酮组,每组20例,分别采用七氟烷吸入麻醉(七氟烷组)和氯胺酮静脉麻醉(氯胺酮组),观察:(1)2组患儿麻醉前(T0)、切皮时(T1)、手术后30 min分(T2)、手术结束时(T3)、心率(HR)、血氧饱和度(Sp O2)、平均动脉压(MAP)变化;(2)2组患儿术后苏醒时间、恶心呕吐及躁动等不良反应发生率等。结果 (1)2组患儿Sp O2各时间监测点比较差异无统计学意义(P0.05)。七氟烷组患儿各时间监测点HR、MAP比较差异无统计学意义(P0.05)。氯胺酮组患儿T1、T2、T3监测点HR、MAP与T0比较,差异有统计学意义(P0.05);2组患儿T1、T2、T3监测点HR、MAP比较,差异有统计学意义(P0.05)。(2)七氟烷组苏醒时间短于氯胺酮组,术后不良反应发生率低于氯胺酮组,比较差异均有统计学意义(P0.05)。结论七氟烷吸入麻醉在小儿短小手术中对循环、呼吸影响小、术后苏醒时间短,不良反应小。     

小儿腭裂修复术的麻醉并发症探讨

我院1985年1月～2001年5月施行1012例腭裂修复术,现将发生并发症的有关问题报道如下. 资料与方法 一般资料 1012例中,男650例,女362例,年龄2～13岁,其中5岁以下小儿771例.手术以单纯修补腭裂为主,同时行唇裂或唇裂术后畸行矫正96例.术前检查除个别患者发育较差,均无其他严重疾患,全部病例均恢复良好出院.     

七氟烷与丙泊酚麻醉诱导用于患儿手术的效果

目的评价七氟烷与丙泊酚麻醉诱导用于患儿手术的效果。方法择期行全麻手术患儿120例,年龄3~12岁,体质量10~40 kg。按照随机数字表法分为2组,每组60例。A组给予七氟烷麻醉诱导,B组给予丙泊酚麻醉诱导。比较2组的麻醉效果、生命体征指标、术后苏醒情况和不良反应发生率。结果2组麻醉优良率差异无统计学意义(P>0.05)。麻醉前、后2组患儿的心率及平均动脉压无明显变化。术后A组患儿睁眼、吞咽反射恢复、定向力恢复等时间短于B组,不良反应发生率低于B组,差异均有统计学意义(P<0.05)。结论七氟烷与丙泊酚麻醉诱导用于患儿手术,均具有良好的麻醉效果,但七氟烷的麻醉安全性优于丙泊酚,有利于患儿术后苏醒。     

小儿唇裂、腭裂修复术的麻醉处理

<正> 小儿唇裂、腭裂修复术时,在麻醉过程中较难处理的就是呼吸道管理问题。如果不进行气管插管,很难确保呼吸道通畅,如进行气管插管麻醉,患儿的风险大大降低。 1 资料与方法 1.1 一般资料:本组368例,其中唇裂170例,腭裂198例,均为5岁以下小儿,最小6个月。术前检查除2例因胸腺增大推迟手术外,全部患儿均无麻醉并发症。 1.2 麻醉装置:①“T”管;②贮气囊(根据年龄一般选择     

Comparison of induction time and characteristics between sevoflurane and sevoflurane / nitrous oxide

A previous investigation using nitrous oxide with 5% enflurane (3.8 MAC) for single breath induction produced a stage of excitement which may be related to the difference in blood/gas coefficient solubility of these agents. The closer blood/gas solubility coefficient of sevoflurane and nitrous oxide may eliminate this phenomenon. We therefore evaluated 40 volunteers in a randomized study using 7.5% sevoflurane (3.7 MAC) in oxygen (n=21) or sevoflurane with nitrous oxide (n=19) using a single breath induction technique. Sevoflurane in nitrous oxide and oxygen reduced induction time by 15% compared to sevoflurane in oxygen alone (41 ±16 and 48±16 sec (s.d.), respectively). This was, however, not statistically significant. There were scarcely induction-related complications, such as coughing, laryngospasm, breath-holding, movements of a limb and excessive salivation, in either group. Thus, the addition of nitrous oxide neither increased the number of complications, nor the speed of induction.     

Anaesthesia with sevoflurane in children: nitrous oxide does not increase postoperative vomiting

BACKGROUND: Nitrous oxide (N2O) has been associated with postoperative nausea and vomiting (PONV), but some studies show conflicting data. The aim of this study was to assess whether the combination of N2O/sevoflurane, in paediatric general anaesthesia, increases the incidence of vomiting in the 24 h following surgery compared with sevoflurane alone. METHODS: One hundred and fourteen children, aged 1-10 years, who underwent testicle and inguinal hernia surgery, were randomized to receive one of the following two anaesthetic regimens: sevoflurane with 70% N2O (group A) or sevoflurane alone (group B). RESULTS: No significant differences were observed in the incidence of postoperative vomiting between the two groups. The overall incidence of postoperative vomiting was 14.9%; 14.3% in group A and 15.5% in group B (P=0.9). CONCLUSIONS: Nitrous oxide used in combination with sevoflurane is not associated with an increase in the incidence of emesis in children who undergo testicle and inguinal hernia procedures.     

Influence of nitrous oxide on induction of anaesthesia with sevoflurane

Nitrous oxide is often used during inhalation induction of anaesthesiawith sevoflurane. Although the value of using nitrous oxideduring inhalation induction with other volatile anaestheticshas been studied, the popularity of sevoflurane induction andthe different characteristics of this agent make a study ofthe combination of nitrous oxide with this agent of interest.We compared induction times, oxygenation, and excitatory eventsduring inhalation induction of anaesthesia using sevoflurane,with and without nitrous oxide. We studied 64 female patients,randomly allocated to receive inhalation induction of anaesthesiausing sevoflurane with or without 50% nitrous oxide in the freshgas, using a co-axial breathing system (Mapleson D) and a freshgas flow rate of 3–6 litre min^–1. Mean time to inductionof anaesthesia (fall of an outstretched arm) was 102 s in bothgroups, but excitation (limb or head movement) was more frequentin those receiving nitrous oxide (10 patients) than in thosereceiving oxygen only (five patients) (P<0.05). Oxygenationwas similar in both groups. We conclude that nitrous oxide confersno advantage when anaesthesia is induced with sevoflurane inthis way. Br J Anaesth 2001; 87: 286–8     

右美托咪定用于小儿唇腭裂手术麻醉的临床观察

目的 探讨右美托咪定用于小儿唇腭裂手术麻醉中的临床效果,为小儿唇腭裂手术麻醉安全用药提供依据.方法 先天性唇腭裂修复术患儿40例,随机分为右美托咪定组(D组)和对照组(C组).两组患儿均采用紧闭面罩8％七氟烷吸入麻醉诱导,D组同时静脉泵注右美托咪定1 μg/kg,C组给予同等容量生理盐水,均于10 min给完.两组患儿均采用气管插管静吸复合全身麻醉方法,术中维持C组采用异丙酚-七氟烷复合麻醉;D组采用右美托咪定-异丙酚-七氟烷复合麻醉,观察并记录不同时点患儿心率、平均动脉压、脉搏血氧饱和度、呼气末二氧化碳分压并进行躁动评分,记录两组呼吸抑制及躁动发生率.结果 两组患儿的手术时间、麻醉时间及苏醒时间差异无统计学意义(P＞0.05).D组患儿在气管插管即刻(T2)、术中20 min(T3)、术毕(T4)及拔管(T5)时平均动脉压和心率均明显低于C组(P＜0.05).D组躁动发生率为11.1％,明显低于C组36.4％(P＜0.05).D组无一例发生呼吸抑制.结论 右美托咪定用于小儿唇腭裂修复术安全有效,术中血流动力学平稳,术后恢复期安静、舒适,能够减少围术期并发症的发生.     

Target-controlled inhalation induction with sevoflurane in children: a prospective pilot study

Background:  Target-controlled inhalation induction (TCII) with sevoflurane is becoming possible with new anesthesia platforms. Although TCII has already been performed in adults, it remains to be evaluated in children.
Methods:  In a prospective study, we compared TCII using the Felix AInOC™ anesthetic station (Taema, Anthony, France) to our standard protocol inhalation induction in children scheduled for elective surgery under general anesthesia. After preoxygenation, sevoflurane induction was performed in both groups without priming of the circuit. Sufentanil was administered after venous line placement.
Results:  In the TCII group, no overdosage or underdosage was observed except in two children where TCII failed owing to high agitation, and the number of adjustments was lower compared with our standard protocol inhalation induction (1(1–2.5[0–5]) vs 6(5–6[4–10]) respectively). Moreover, the delay to obtain target end-tidal sevoflurane concentration was shorter in the TCII group (2(1.6–2.7[1.3–4]) min vs 3.4(2.5–3.8[2.3–6.5]) min respectively). No significant difference in the delay of loss of consciousness or in the conditions for intubation or laryngeal mask placement was observed between the groups.
Conclusion:  The Felix AInOC™ allows TCII to be performed satisfactorily in children. Manual inhalation induction induced a higher number of adjustments and overdosages.     

七氟烷吸入麻醉对行腹腔镜疝修补术患儿呼吸、应激及不良反应的影响

目的探讨七氟烷吸入麻醉对行腹腔镜疝修补术患儿呼吸参数、补体水平、躁动及恶心呕吐的影响。方法选取2016年7月至2019年6月在海南省妇女儿童医学中心行腹腔镜疝修补术患儿118例作为研究对象。按照随机数表法,将所有患者分为研究组和对照组,各59例。对照组患者给予氯胺酮麻醉,研究组患者给予七氟烷吸入麻醉,比较麻醉前(T0)。麻醉结束时(T1)、手术开始时(T2)、手术结束时(T3)的呼吸参数,并比较手术前后的补体水平和术中躁动及术后恶心呕吐情况。结果2组患者在T1、T2、T3时的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO₂)明显降低T0时。2组患者在T1、T2、T3时的舒张压(DBP)明显升高T0时。研究组患者在T2、T3时的收缩压(SBP)明显高于T0时,对照组患者T1、T2、T3时的SBP明显高于T0时,且差异有统计学意义(P<0.05);研究组患者在T1、T2、T3时的HR、MAP明显高于对照组,研究组患者在T1、T2、T3时的DBP、SBP明显低于对照组,研究组患者T2时的SpO₂明显高于对照组,差异均有统计学意义(P<0.05)。术后2组患者的补体C3、补体C4水平均降低,研究组的补体C3、补体C4水平明显高于对照组,差异有统计学意义(P<0.05)。研究组患者的躁动、恶心呕吐发生率分别为1.69%、3.39%,高于对照组(3.39%、8.47%),差异均无统计学意义(P>0.05)。结论对行腹腔镜疝修补术患儿采用七氟烷吸入麻醉,可降低对呼吸循环的影响,减少对机体脏器的损伤,具有较高的安全性。