丙泊酚和七氟烷在小儿全身麻醉中对血流动力学及术后苏醒质量影响的比较研究

[摘要]目的:探讨丙泊酚与七氟烷对小儿血流动力学及术后苏醒质量的影响,评价其对患儿的麻醉效果。方法:选择2015年在我院行外科手术的小儿238例,随机分为丙泊酚组和七氟烷组各119例,比较两组患儿麻醉诱导前3 min、手术开始3 min后、手术结束前 3 min、拨管后5 min 的收缩压(SBP)、舒张压(DBP)、心率(HR)和两组患儿的麻醉诱导时间、苏醒时间、自主呼吸恢复时间、拔管时间、定向力恢复时间、术后躁动例数、躁动评分及不良反应。 结果:丙泊酚组 SBP、DBP 与 HR 不同时点比较差异均有统计学意义(P均<0.05),七氟烷组SBP、DBP与HR水平不同时点比较差异均无统计学意义(P均>0.05)。丙泊酚组的苏醒时间、自主呼吸恢复时间、拔管时间与定向力恢复时间均长于七氟烷组(P均<0.05),两组患儿麻醉诱导时间比较差异无统计学意义(P>0.05)。两组患儿术后躁动率、镇静躁动评分比较,差异均无统计学意义(P均>0.05)。两组患儿恶心、呕吐、分泌物增多、支气管痉挛等不良反应发生率比较差异均无统计学意义(P均>0.05)。结论:七氟烷吸入麻醉对患儿的血液动力学影响较小,苏醒质量更高,是小儿外科手术较为理想的麻醉方式。

Influence of Propofol and Sevoflurane on Hemodynamics and Postoperative Recovery in Pediatric General Anesthesia

[Abstract]Objective: To investigate the influence of propofol and sevoflurane on hemodynamics and postoperative recovery in pediatricgeneral anesthesia, and to evaluate their effects of anesthesia. Methods: A total of 238 children accepting surgery in 2015 in our hospital were randomly selected and divided into propofol intravenous anesthesia group (119 cases) and sevoflurane inhalation anesthesia group (119 cases). The SBP, DBP, HR at different time in perioperative period, the anesthesia induction time, awaking time, spontaneous breathing recovery time, extubation time, orientation recovery time, indexs of postoperative agitation, agitation score and adverse reactions between two groups were observed and compared. Results: The differences of SBP, DBP and HR at different time of propofol group were statistically significant (P<0.05), and those of sevoflurane group were not statistically significant (P>0.05). The SBP, DBP and HR per min of patients in propofol group at 3 min after surgery were lower than those before anesthesia induction (P<0.05) and those in sevoflurane group, respectively at 3 min after surgery (P<0.05). The awaking time, spontaneous breathing recovery time, extubation time and orientation recovery time in propofol group were longer than those in sevoflurane group (P<0.05). The differences of adverse reactions, the number of postoperative agitation and agitation scores between two groups were not statistically significant (P>0.05). Conclusions: Sevoflurane have smaller influence on hemodynamics in pediatric patients and better recovery quality, and is ideal anesthesia mode for pediatric surgery.