七氟醚全凭吸入麻醉在婴儿唇裂整复术中的应用.pdf

学杂志2011年2月第27卷第2期JClinAnesthesiol,February2011,Vo1．27,No．2
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．临床研究·

七氟醚全凭吸人麻醉在婴儿唇裂整复术中的应用

王新河邵云李刚

【摘要】目的探讨七氟醚全凭吸人麻醉在婴儿唇裂整复术中应用的可行性和安全性。方
法6O例ASAI级唇裂婴儿随机均分为七氟醚全凭吸人麻醉组(S组)和丙泊酚一芬太尼静脉麻醉组
(P组)。记录患儿入室后、气管插管时、手术切皮时、手术开始后30rain的HR、MAP；记录拔管时
间、改良Aldrete评分达9分所需时问、单位时问维库溴铵用量、苏醒期躁动及术后恶心呕吐情况。
结果P组气管插管时HR明显快于入室后及S组(P<o．01)；S组拔管时间和改良Aldrete评分到
9分的时间均明显短于P组(P<O．01)；S组苏醒期躁动例数多于P组(P<O．05)；两组患儿均无苏
醒期呕吐；S组患儿的维库溴铵用量显著小于P组(P<O．01)。结论七氟醚全凭吸入麻醉维持平
稳，苏醒迅速完全，可安全用于婴儿唇裂整复手术，其不足是苏醒期躁动发生率高。
【关键词】七氟醚；全凭吸入麻醉；婴儿；唇裂

TheapplicationoftotalinhalationalanesthesiawithsevofluraneforcleftliprepairininfantsWANG
Xin—he，SHAOYun，，J，Gang．DepartmentofAnesthesiology，SchoolandHospitalofStomatology，
NanjingUniversityMedicalCenter，Naniing210008，China
[Abstract]ObjectiveTocomparethefeasibilityandsafetybetweentotalinhalationanesthesia
withsevoflurane1andpropofol—fentany1intravenousanesthesiaincleftliprepairininfants．Methods
SixtycleftlipinfantswithASAlgradewererandomlydividedintogroupS(sevofluranegroup，一
30)andgroupP(propofol—fentanylgroup。”一30)．MAPandHRbeforeanesthesiainduction，during
endotracheaintubationandincision，3Ominafterthebeginningofoperationwererecorded
respectively．Theextubationtime，thetimewhenmodifiedAldretescorereachedtO9，thedosageof
vecuronium，andtheincidenceofagitationandvomitingwerealsorecorded．ResultsHRingroupS
wasmorestablethanthatingroupPduringtrachealintubation．Theextubationtimeandthetime
whenmodifiedAldretescorereachedtO9ingroupSweresignificantlydecreased．(P<0．01)．The
incidenceofagitationingroupSwashigherthanthatingroupP(P％0．01)．Therewasnostatistical
significanceintheincidenceofvomitingbetweenthetwogroups．Thedosageofvecuroniumingroup
SwaslowerthanthatingroupP(尸<0．01)．ConclusionTotalinhalationalanesthesiawith
sevofluraneisasteadyanesthesiamethodforinfantcleftliprepairwithquickrecoverybutahigh
incidenceofagitation．
[KeywordslSevoflurane；Totalinhalationanesthesia；Infants；Cleftlip

为尽早恢复上唇的形态和功能，唇裂患儿多在
资料与方法
婴儿期接受整复手术。患儿年龄小，手术部位位于

呼吸道附近，选择合适的麻醉药物和麻醉方法对保一般资料选择先天性上唇裂患儿60例。男
证手术顺利进行和患儿安全尤为重要。七氟醚