七氟醚与异氟醚用于婴幼儿唇腭裂修复术的麻醉效果比较

摘要

Objective To compare the anesthetic efficacy of sevoflurane with that of isoflurane in surgical repair of cleft lips and cleft palates in infants and young children.Methods 100 ASA Ⅰ-Ⅱ infants and young children undergoing surgical repair were randomly assigned to receive sevoflurane ( 50 patients,sevoflurane group ) or isoflurane ( 50 patients,isoflurane group ) for maintaining general anesthesia.Time to awakening from medication termination,time to extubation,time to full consciousness,and incidence rate of complications were observed; Fa/Fi and levels of creatinine and urea nitrogen 24 h after surgery were noted.Results Time to awakening,time to extubation,and time to full consciousness was significantly shorter in sevoflurane group than in isoflurane group ( P＜ 0.05 ）, the incidence rate of complications was significantly lower in sevoflurane group than in isoflurane group ( P＜ 0.05 ).Fa/Fi within 20 min was significantly greater in sevoflurane group than in isoflurane group ( P＜ 0.05 ) ; levels of creatinine and urea nitrogen did not differ significantly between these 2 groups 24 h after surgery ( P ＞ 0.05 ).Conclusions Sevoflurane is safer and has a better anesthetic efficacy in surgical repair of cleft lips and cleft palates in infants and young children.%目的 观察比较七氟醚或异氟醚用于婴幼儿唇腭裂修复术的麻醉效果.方法 选择ASA Ⅰ ～Ⅱ级的择期行唇腭裂修复术的婴幼儿100例,将其随机分为两组:S组(七氟醚组,50例)采用七氟醚维持全身麻醉；Ⅰ组(异氟醚组,50例)采用异氟醚维持全身麻醉.观察两组患儿停药至苏醒时间、气管拔管时间、完全清醒时间及苏醒期并发症的发生率；并记录两组患儿的Fa/Fi及术后24 h的肌酐与尿素氮水平.结果 S组苏醒、拔管及清醒时间较Ⅰ组明显缩短(P＜ 0.05),苏醒期并发症较Ⅰ组明显减少(P＜0.05).S组20 min内的Fa/Fi明显高于Ⅰ组(P＜0.05),术后24 h两组的肌酐及尿素氮水平无明显差异(P＞0.05).结论 婴幼儿唇腭裂修复术中采用七氟醚麻醉较异氟醚麻醉苏醒更快且更安全.