七氟醚与异丙酚联合瑞芬太尼麻醉在小儿腹腔镜疝气手术中的临床应用.docVIP

七氟醚与异丙酚联合瑞芬太尼麻醉在小儿腹腔镜疝气手术中的临床应用 摘要：目的 观察七氟醚与异丙酚联合瑞芬太尼麻醉在小儿腹腔镜疝气手术中的麻醉效果、不良反应及对麻醉复苏的影响。方法 选取2015年1月至2016年10月在我院接受腹腔镜疝气手术的80例患儿作为研究对象，ASAI或II级，根据不同麻醉方法分为七氟醚+瑞芬太尼麻醉（A组）以及异丙酚+瑞芬太尼麻醉（B组）各40例，分别记录麻醉诱导前、插管后、人工气腹时、气腹后5min以及术毕时的MAP、HR、SpO2指标MAP在插管后均略有增加，建立人工气腹时、气腹5min时，B组MAP与麻醉诱导前相比差异有统计学意义（P＜0.05），在插管后、气腹后5min A组和B组平均动脉压相比差异有显统计学意义(P0.05)；两组患儿HR在插管后较插管前有显著性增加(P0.05)，在建立气腹后5minB组HR有较明显下降(P0.05)；术中应激指标A组低于B组(P0.05)；术毕至睁眼时间和拔管时间A组比B组短(P0.05) ，不良反应发生率A组低于B组(P0.05) 。结论 七氟醚联合瑞芬太尼麻醉应用于小儿腹腔镜疝气手术能使术中血流动力学更加稳定，减轻患儿术中的应激反应，术后复苏快且不良反应少，具有可靠的安全性和有效性，是小儿腹腔镜疝气手术理想的麻醉方法。 关键词：七氟醚；异丙酚；瑞芬太尼；小儿；腹腔镜手术 Clinical application of sevoflurane or propofol combined with remifentanil anesthesia for pediatric laparoscopic hernia surgery. [Abstract] Objective To observe the effects,adverse reactions and awakening of anesthesia of sevoflurane or propofol combined with remifentanil anesthesia for pediatric laparoscopic hernia surgery.Methods Retrospective analysis 120 cases children with underwent a laparscopic hernia operation,AsA I～Ⅱgrade，were randomly divided into two groups(n=60): Sevoflurane+remifentanil(A groups)，propofol+remifentanil（B groups），were recoIded before induction of anesthesia,after intubation, pneumoperitoneum established, pneumoperitoneum afer 5min and surgery canceled when the mean arterial pressure,heart rate, oxygen saturation; stress index;surgery records of children operative time, opening eyes, extubation time and side effects such as nausea and,dysphoria and vomiting. Results The mean arterial pressure compared with before induction,after induction were slightly increased.In B group pneumoperitoneum established, pneumoperitoneum afer 5min mean arterial pressure were significantly different(P＜0.05)with induction of before anesthesia.After intubation and pneumoperitoneum afer 5min A and B group mean arterial pressure were significantly different(P＜0.05). Two group of children with heart rate after induction compared with before intubation was significantly different(P＜0.05),afte