小儿在不同浓度七氟醚吸入麻醉下行静脉穿刺的临床观察

目的 探讨实施小儿静脉穿刺时的最佳七氟醚吸入浓度.方法 选取6个月～36个月的择期手术患儿150例,随机分为3组,每组50例.A组吸入8%七氟醚,B组吸入6%七氟醚,C组吸入4%七氟醚,氧流量均为4 L/min.3组均在患儿睫毛反射消失后行静脉穿刺.记录入室后、穿刺前和穿刺后即刻的生命体征变化情况,记录从麻醉开始至睫毛反射消失的时间（T1）,静脉穿刺完成所用时间（T2）和首次穿刺成功率,肢体运动情况及并发症.结果 3组静脉穿刺完成所用时间分别为（95.5±2.50）s,（99.1±2.85）s和（150.5±4.72）s,A组和B组与C组相比,差异有统计学意义（P〈0.05）;首次穿刺成功率分别为98%、98%和62%,3组肢体运动评级达1级者分别为49（98%）、48（96%）和1（2%）,A组、B组与C组间差异均有统计学意义（P〈0.05）.结论 6%的七氟醚诱导迅速,麻醉深度适宜,不良反应发生率低,可安全应用于小儿静脉穿刺的吸入诱导.

Clinical observation of venipuncture on infant with different inhalation concentration of sevoflurane

Objective To explore the appropriate inhalation concentration of sevoflurane when the venipuncture is imple- mented on infant. Methods 150 infants with elective surgery, 6 to 36 months old, were randomly divided into three groups （50 cases in each group）. The inhalation concentration of sevoflurane was 8% in group A, 6% in group B and 4% in group C. The oxygen flow rate was 4L/min. The venipuncture was carried out after the infant＇ s lash reflex disappeared. The vital signs after en- tering the operating room, before venipuncture and instantly after venipuncture were recorded. The time from starting of anesthesia to disappearance of lash reflex （T1 ）, the time during venipuncture （T2 ）, the success rate of the first puncture, the limb move- ment rating and the complications also were recorded. Results The times of the vein puncture were （95.5±2.50） s, （99.1 ± 2.85） s and （150.5±4.72）s, group A or B compared with group C, the difference was statistically significant （P 〈 0. 05）. The difference of the first success rate and the limb movement rating between group A or B and group C was statistically significant （P 〈 0. 05）. Conclusion 6% sevoflurane could be safely used in inhalation induction on pediatric venipuncture, because of the rapid induction, suitable depth of anesthesia and low incidence of adverse reactions.