骶管阻滞对小儿七氟烷最低肺的泡清醒浓度的影响.pdfVIP

中国医科大学学报 第38 卷 第12 期 2009 年12 月 937 Journal of China Medical University Vol.38 No.12 Dec. 2009 · · 骶管阻滞对小儿七氟烷最低肺泡清醒浓度的影响 成忠平，陈卫民，陈培红 （中国医科大学附属盛京医院麻醉科，沈阳110004） 摘要：目的 探讨骶管阻滞对小儿七氟烷最低肺泡清醒浓度（MAC-awake）的影响。方法 选择60 例（2～8 岁）择期行泌尿外科 手术患儿，随机分为2 组：Ⅰ组（单纯吸入全麻组）和Ⅱ组（骶管阻滞复合全麻组），每组30 例。患儿麻醉前30 min 肌肉注射 阿托品0.01 mg/kg ，Ⅱ组经骶管裂孔给予0.25%罗哌卡因1 ml/kg，两组麻醉诱导和术中维持均用七氟烷且均不行气管插管，保 留自主呼吸，手术结束时维持呼气末七氟烷目标浓度 10 min，根据序贯法记录患儿清醒睁眼睛时呼气末七氟烷浓度，通过 probit 检验计算两组的MAC-awake 值（ED ）。结果 Ⅱ组七氟烷MAC-awake （0.39%）明显低于Ⅰ组（0.62%），2 组之间差异有统 50 计学意义（P 0.01）。结论 骶管阻滞能降低小儿七氟烷最低肺泡清醒浓度。 关键词：麻醉；脊尾；小儿；吸入；最低肺泡浓度；七氟烷 中图分类号：R614.4 文献标志码：A 文章编号：0258-4646 （2009）12-0937-02 The Influence on MAC-awake of Sevoflurane by Sacral Block in Children CHENG Zhong-ping ，CHEN Wei-min ，CHEN Pei-hong （Department of Anesthesiology，Shengjing Hospital ，China Medical University，Shenyang 110004，China） Abstract ：Objective To investigate the influence on MAC-awake of sevoflurane by sacral block in children. Methods 60 patients （2～8 years old）undergoing urogenital surgery were randomly allocated to receive general anesthesia group （group Ⅰ，n =30）or combined general- sacral block anesthesia group （group Ⅱ，n =30）.The patients were premedicated with intramuscular atropine 0.01 mg/kg 30 min before anes－ thesia . In group Ⅱ，we used inhalation combined with sacral block （0.25% Ropivacaine 1 ml/kg）. All patients keep respiration without intu－ bation. Anesthesia was maintained with sevoflurane，at the end of surgery ，a predetermined end-tidal sevoflurane concentration was maintained for at least 10 min before a standard stimulus was applied and an observer determined if the child was awake. The Dixon up-down method was used to determine the progression of subsequent concentration ，the MAC-awake （ED50）for the two groups w