七氟醚和氯胺酮在小儿扁桃体切除术中麻醉诱导效果比较

【目的】探讨七氟醚、氨胺酮用于小儿扁桃体切除术麻醉诱导效果以及对患者苏醒期躁动期的影响。【方法】本院收治的行扁桃体切除术患儿120例，随机分为七氟醚组（n=60）和氯胺酮组（n=60），在患儿给予苯巴比妥及阿托品进行全麻之后分别采用七氟醚及氯胺酮麻醉诱导，比较两组患儿麻醉诱导效果以及苏醒期躁动情况。【结果】两组患儿均能够顺利进行手术治疗，并且麻醉效果均良好，无严重事故发生；七氟醚组患儿较氟胺酮组手术时间、拔管时间、苏醒时间均缩短，且两组相比较差异有显著性（P〈0．05）；七氟醚组患儿支气管痉挛发生率、脉搏氧饱和度（SpO2）不稳定发生率均较氯胺酮组显著降低（P〈0．05）；两组患者拔管前平均动脉压（MAP）及心率（HR）差异均无显著性（P〉0．05），拔管后、拔管后5min七氟醚组患儿HR显著高于氟胺酮组（P〈0．05），而拔管后七氟醚组MAP显著高于氯胺酮组（P〈0．05），拔管后5min则差异无显著性（P〉0．05）；七氟醚组患儿躁动发生率为15．00％（20／60）显著低于氯胺酮组63．33％（38／60），且两组相比较差异具有显著性（P〈0．05）；七氟醚组躁动评分显著低于氯胺酮组（P〈0．05）。【结论】七氟醚较氯胺酮会导致患儿，HR加快、MAP增高，但是能在较短时间内快速恢复；但七氟醚与氯胺酮相比麻醉平稳，患儿术后苏醒快、麻醉时间短、血流动力学平稳、副作用发生率小，苏醒期躁动情况少，更适合于小儿手术。

Comparative Analysis of Sevoflurane and Ketamine on Pediatric Tonsillectomy Anesthesia In-duction and Recovery Period

Obj ective]Comparative analysis of the effects of sevoflurane and ketamine anesthesia on pedi-atric tonsillectomy patients'induction and restlessness.This will provide the basis for clinical anesthesia medi-cation.Methods]120 cases of children who received treatment for tonsillectomy in our hospital were randomly divided into a sevoflurane group(n=60)and a ketamine group(n=60).After induction of anesthesia by phe-nobarbital and atropine,children received sevoflurane and ketamine,respectively .Anesthesia induction and restlessness situation were compared between the two groups.Results]The patient groups were able to suc-cessfully carry out surgery,and anesthetic effects are good.There were no serious accidents.However,chil-dren in the sevoflurane group had shorter operative times,extubation times,and recovery times than children in the ketamine;the difference was statistically significant (P <0.05).The incidence of children with bron-chospasm and SpO2 instability were significantly lower in the sevoflurane than in the ketamine group (P <0.05).Before extubation,MAP and HR of the two groups had no significant difference (P >0.05).5min af-ter extubation,the number of children with HR was significantly higher in the sevoflurane group than in the ketamine group (P <0.05).After extubation,MAP in the sevoflurane group was significantly higher than in the ketamine group (P <0.05),but showed no significant difference later (P >0.05).Agitation incidence was 15.00% in the sevoflurane group and 63.33% in the ketamine group;the difference was statistically signif-icant (P <0.05).This shows that the agitation score of the sevoflurane group was significantly lower than that of the ketamine group.The difference was statistically significant (P <0.05).Conclusion]Sevoflurane in children can cause a rapid heart rate and an increase in mean arterial pressure,but also allows for a quicker re-covery compared to ketamine.However,ketamine anesthesia is more stable than sevoflurane.It allows for rap-id recovery after surgery,a short anesthesia time,smooth hemodynamics,low incidence of side effects,few cases of restlessness.Ketamine is more suitable for children.