七氟醚、地氟醚与氯胺酮用于小儿阑尾切除术麻醉效果比较

目的比较七氟醚、地氟醚、氯胺酮用于小儿阑尾切除术麻醉效果。方法将72例需手术治疗急性阑尾炎的患儿随机分为七氟醚组、地氟醚组、氯胺酮组，每组24例，记录三组患儿术中麻醉效果、诱导和苏醒时间、术中摇头和肢体活动、安全离手术室时间，定向力恢复时间以及术后呕吐等指标。结果三组麻醉效果近似（P〉0．1），麻醉诱导和苏醒时间、定向力恢复时间、安全离开手术室的时间七氟醚组和地氟醚组明显短于氯胺酮组（P〈0．01，P〈0．05）。患儿术中出现摇头、肢体活动，七氟醚组、地氟醚组明显少于氯胺酮组（P〈0．01）。三组术后呕吐发生率差异不显著（P〉0．05）。结论急性阑尾炎小儿行阑尾切除术，面罩吸人七氟醚、地氟醚的麻醉效果总体质量优于氯胺酮静脉麻醉。

Anesthetic effect of sevoflurane,desflurane with ketamine for acute appendicitis in children

Objective To compare the anesthetic effect of sevoflurane, desflurane with ketamine for acute appendicitis in children. Meth- ods 72 patients required surgical treatment of acute appendicitis were randomly assigned into three groups：sevoflurane, desflurane and ketamine groups. We recorded the indicators includins anesthetic effect, induction time, recovery time, intraoperative shook of head, physi- cal activity, safe departure time from the operating room, orientation recovery time and postoperative vomiting for three groups of children in surgery. Results The anesthetic effects for three groups had no significant difference （P 〉 0.1 ）. The anesthesia induction time and re- covery time for sevoflurane group and desflurane group was significantly shorter than that in the ketamine group （ P 〈 O. O1 ）. The time of orientation recovery and safe departure from the operating room for sevoflurane group and desflurane group was significantly shorter than that in the ketamine group （ P 〈 O. 05 ）. As for shaking head during surgery and physical activity, sevoflurane, desflurane group was signif- icantly less than the ketamine group （ P 〈 O. O1 ）. Postoperative vomiting in three groups had no significant difference （P 〉 O. 05 ）. Con- clusions The anesthetic effect for mask inhalation of sevoflurane or desflurane is better than ketamine intravenous anesthesia,which is a better method of anesthesia for children with acute appendicitis surgery.