七氟醚全麻在小儿腹腔镜疝修补术中应用.docVIP

七氟醚全麻在小儿腹腔镜疝修补术中的应用 　　[摘要] 目的 探讨七氟醚吸入麻醉在腹腔镜下小儿疝修补术的临床应用效果。方法 方便选取2014年8月―2017年3月该院收治的小儿腹股沟疝修补术的患儿126例，平均分为2组，A组七氟醚诱导麻醉，B组肌肉注射氯胺酮诱导麻醉。分别观察两组生命体征变化。结果 七氟醚吸入麻醉后A组患儿入睡时间（2±1）min较B组明显缩短，清醒时间（10±2）min明显快于B组，两组比较差异有统计学意义（P0.05）。结论 七氟醚吸入诱导全麻，小儿入睡快，术中心率、血压变化小，术毕苏醒快，值得临床推广应用。 　　[关键词] 七氟醚；腹腔镜；小儿疝修补术；氯胺酮 　　[中图分类号] R726 [文献标识码] A [文章编号] 1674-0742（2018）01（b）-0129-03 　　[Abstract] Objective To discuss the application effect of sevoflurane general anesthesia in laparoscopic herniorrhaphy in children. Methods 126 cases of children with laparoscopic herniorrhaphy admitted and treated in our hospital from August 2014 to March 2017 were convenient selected and divided into two groups with 63 cases in each， the group A adopted the sevoflurane for induced anesthesia， while the group B adopted the muscular injection of ketamine for induced anesthesia， and the changes of vital signs were compared between the two groups. Results The sleep latency time in the group A was obviously shortened compared with that in the group B， which was （2±1）min in the group A， and the awakening time was （10±2）min， which was obviously faster than that in the group B， and the differences were statistically significant（P0.05）. Conclusion The sleep latency time of sevoflurane for induced anesthesia is rapid with less intraopaoperative heart rate， small blood pressure change and rapid analepsis after surgery， which is worth clinical promotion and application. 　　[Key words] Sevoflurane； Laparoscope； Laparoscopic herniorrhaphy in children； Ketamine 　　吸入麻醉?至今已长达170余年，其机制尚未阐明[1]。由于小儿手术多数只能选择全麻下完成，临床上腹腔镜下小儿疝修补术的全麻诱导方法较多，药物配伍复杂，临床效果也不尽相同，由于小儿的生理及心理特点，患儿通常害怕注射或输液，哭闹不合作，采用合适的麻醉方式使小儿容易接受而且麻醉效果显著又安全是临床麻醉医生关注的课题，该院自2014年8月―2017年3月共收治年龄8个月～4岁小儿腹股沟疝126例，分别采用了七氟醚诱导全麻及肌注氯胺酮诱导全麻下行腹腔镜小儿疝修补术，将两组全麻效果进行比较，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　该研究经医院批准及家属同意并签定知情同意书，方便选取单侧腹股沟疝患儿126例，行微创腹腔镜下疝修补术。年龄8个月～4岁，体重9～16 kg，ASAⅡ～Ⅲ，术前1周内无感冒发热，术前常规各项检查无明显异常及手术禁忌证。随机将其分为A组（七氟醚组）和B组（氯胺酮组）。A组63例，男49例，女14例；B组63例，男49例，女14例；126例手术均为同一主刀医生完成手术。手术时间15～25