七氟烷吸入麻醉在儿童口腔日间全麻手术中的临床应用

摘要

Objective To observe the clinical effect of sevolfurane inhalation anesthesia in the children suffered from dental day-case dental treatment.Methods Fifty children aged from 2 to 10 years, suffered from day-case dental treatment, were included and divided into two groups,2-5 years old group(A).6-10 years old group(B).The decayed tooth filling, root canal therapy and retenting deciduous teeth extraction were performed under sevoflurane inhalation anesthesia. The anesthesia induction time, the disappearing time of eyelash relfex, consciousness and pain response and the postoperative recovery time were recorded. The respiratory rate, heart rate, blood pressure, oxygen saturation were observed before and after sevolfurane inhalation.Results All the treatments were uneventfully ifnished. There was no signiifcant difference in the heart rate, respiratory rate, blood pressure, oxygen saturation, anesthesia time, the disappearing time of eyelash relfex, pain response, the postoperative recovery time of consciousness between the two groups.(P>0.05).The rate of Postoperative delirium in group A[40%(10/25)] is higher than in group B[12%(3/25)(P<0.05)].Conclusions Sevolfurane inhalation anesthesia was a safe and reliable method to eliminate dental phobia in children.%目的：探讨七氟烷吸入麻醉在儿童口腔日间全麻手术麻醉中的临床效果及安全性，以期为临床提供参考。方法选择我院2014年3月至2014年8月就诊于麻醉科，择期行全麻下儿童日间口腔治疗患儿50例，按照美国麻醉协会（ASA）分级Ⅰ~Ⅱ级，年龄2~10岁，按年龄分为学龄前组（2~5岁）及学龄组（6~10岁），每组25例。在七氟烷吸入麻醉状态下进行龋齿填充、根管治疗、多生埋伏牙拔除等口腔治疗，全程记录麻醉诱导、苏醒时的意识反应消失时间、睫毛反射消失时间、疼痛反应消失时间及术后意识恢复时间，并全程观察七氟烷吸入前后和治疗时的心率、平均动脉压、呼吸、血氧饱和度的变化情况和术后躁动发生情况。结果在七氟烷吸入麻醉状态下的口腔治疗全程，两组患者的口腔治疗完成情况均为良好，且心率、呼吸、平均动脉压、血氧饱和度的变化，以及吸入诱导、苏醒时意识反应消失时间、睫毛反射消失时间、疼痛反应消失时间以及术后意识恢复时间的变化情况无统计学意义（P>0.05)；学龄前组躁动发生率40%（10/25)明显高于学龄组；12%（3/25)，差异有统计学意义（P<0.05)。结论七氟烷吸入麻醉在儿童口腔日间全麻手术麻醉中的临床效果稳定，安全可靠。