临床深麻醉下拔管在先天性唇裂手术麻醉中的可行性研究

目的探讨先天性唇裂手术麻醉中采用深麻醉下拔管的可行性。方法将2012年12月—2013年12月该院接收的60例先天性唇裂患儿分为观察组与对照组,各30例。在全麻的基础上,对照组于清醒后拔管,观察组于深麻醉下拔管,对比两组患儿不同节点的HR、Sp O2、面罩给氧、PETCO2以及患儿支气管痉挛、喉痉挛、躁动等情况。结果观察组患儿T1、T2节点的Sp O2分别为3.33%、10.0%,低于对照组36.37%、53.33%。T1、T2节点观察组无支气管痉挛、喉痉挛、躁动以及面罩给氧困难发生,对照组发生率分别为20.0%、33.33%、70.0%、60.0%,40.0%、26.67%、33.33%、50.0%,明显高于观察组的分别为0（P〈0.05）。结论先天性唇裂手术麻醉中采用深麻醉下拔管,可降低并发症发生率,安全可行,值得推广。

Feasibility Study of Extubation under Clinical Deep Anesthesia Used in the Anesthesia for Congenital Cleft Lip Surgery

Objective To explore the feasibility of extubation under deep anesthesia used in the anesthesia for congenital cleft lip surgery. Methods 60 children with congenital cleft lip were divided into the observation group and the control group with 30 pa- tients in each. Based on the general anesthesia, the control group underwent extubation after postanaesthetic recovery, while the observation group underwent extubation under deep anesthesia. The HR, SpO2, mask oxygen inhalation, PETCOz, bronchial spasm, laryngospasm, restlessness and so on at different time points were compared between the two groups of children. Results The SpO2 of the observation group at T1, T2 was 3.33%, 10.0%, respectively, lower than 36.37%, 53.33% of the control group, respectively. In the observation group, no bronchial spasm, laryngospasm, restlessness and mask oxygen inhalation difficulties occurred at T1 and T2, the incidence of bronchial spasm, laryngospasm, restlessness, mask oxygen inhalation difficulties was 0%, 0%, 0%, 0% at T1 and T2, respectively; in the control group, the incidence of bronchial spasm, laryngospasm, restlessness, mask oxygen inhala- tion difficulties at T1 was 20.0%, 33.33%, 70.0%, 60.0%, respectively, and at T2 that was 40.0%, 26.67%, 33.33%, 50.0%, re- spectively, the incidence of bronchial spasm, laryngospasm, restlessness and mask oxygen inhalation difficulties in the control group at T1 and T2 was much higher that in the observation group, respectively（P〈0.05）. Conclusion Extubation under deep anes- thesia used in the anesthesia for congenital cleft lip surgery can reduce the incidence of complications with safety and feasibility, so it is worthy of promotion.