两种低流量麻醉药物用于小儿腹腔镜手术的回顾性分析

摘要

OBJECTIVE:To evaluate therapeutic efficacy and safety of two low-flow anesthesia drugs for pediatric laparoscop-ic surgery. METHODS:72 children underwent laparoscopic surgery in our hospital during Jan. 2012 to Dec. 2014 were collected retrospectively,and divided into trial group and control group,with 36 cases in each group. According to body weight,trial group was given sevoflurane 0.1 mg/kg and oxygen flow rate 0.6 L/min for anesthesia before surgery. The anesthesia induction time,AP, HR,SpO2 and pEtCO2 before surgery,during anesthesia induction and maintenance of anesthesia and at the end of surgery,recov-ery time,extubation time,dysphoria,nausea and vomiting after awake up were compared in 2 groups. RESULTS:Compared with before anesthesia,AP,HR and pEtCO2 of 2 groups were increased significantly,with statistical significance(P0.05). HR,AP and pEtCO2 of trial group were lower than those of control group after pneumoperitoneum,with statistical significance(P<0.05). After operation,recovery time,extubation time and the proportion of dysphoria in trial group were shorter or lower than control group, with statistical significance (P<0.05). CONCLUSIONS:The sevoflurane anesthesia has little effect on blood pressure and HR of patients,has short recovery time and extubation time,little side effects and good clinical efficacy.%目的：评价两种低流量麻醉药用于小儿腹腔镜手术的效果及安全性。方法：回顾性收集我院2012年1月－2014年12月收治的行腹腔镜手术治疗的72例患儿资料，按照手术前使用麻醉药不同分为试验组和对照组，各36例。根据患儿体质量，试验组患儿使用七氟烷0.1 mg/kg、氧流量0.6 L/min行术前麻醉，对照组患儿使用异氟烷0.1 mg/kg、氧流量0.6 L/min行术前麻醉。比较两组患儿麻醉诱导时间和麻醉前、诱导期、气腹后及手术结束后的动脉压（AP）、心率（HR）、血氧饱和度（SpO2）、呼气末二氧化碳分压（pEtCO2）及苏醒时间、拔管时间和苏醒后躁动、恶心呕吐等指标。结果：与麻醉前比较，两组患儿气腹后AP、HR、pEtCO2均显著升高，差异有统计学意义（P＜0.05），诱导期和气腹后SpO2无显著变化，差异无统计学意义（P＞0.05）；试验组患儿气腹后HR、AP、pEtCO2均低于对照组，差异有统计学意义（P＜0.05）；试验组患儿术后苏醒时间和拔管时间、躁动所占比例均短于或低于对照组，差异有统计学意义（P＜0.05）。结论：七氟烷麻醉对患儿机体血压、HR等影响较小，术后苏醒时间与拔管时间较短，副作用小，具有良好的临床效果。