【摘要】 目的 比較喉罩-七氟醚、雷米芬太尼與喉罩-丙泊酚、雷米芬太尼兩種麻醉方法在小兒短小手術(shù)應(yīng)用中的優(yōu)缺點(diǎn)。 方法 2009年3-9月，將40例擇期行斜疝手術(shù)或隱睪下降固定術(shù)的患兒，隨機(jī)分為A、B組，各20例。A組施喉罩+七氟醚+雷米芬太尼，B組施喉罩+丙泊酚+雷米芬太尼。觀察誘導(dǎo)時(shí)間、術(shù)中生命體征、蘇醒時(shí)間、麻醉后恢復(fù)室（PACU）停留時(shí)間、圍術(shù)期并發(fā)癥。 結(jié)果 麻醉前兩組患兒血壓及心率無統(tǒng)計(jì)學(xué)差異，麻醉后B組各時(shí)點(diǎn)血壓及心率明顯低于麻醉前水平，且B組各時(shí)點(diǎn)血壓及心率明顯低于A組，A組血壓及心率在麻醉前后比較無統(tǒng)計(jì)學(xué)差異。B組麻醉誘導(dǎo)時(shí)間明顯短于A組。A組術(shù)后躁動(dòng)發(fā)生率明顯高于B組。 結(jié)論 與喉罩+丙泊酚+雷米芬太尼相比，喉罩+七氟醚+雷米芬太尼具有對(duì)全身影響小、麻醉平穩(wěn)等特點(diǎn)，但麻醉誘導(dǎo)時(shí)間長(zhǎng)，術(shù)后躁動(dòng)發(fā)生率高。
引用本文： 戴貴茂,李秀澤,李衛(wèi). 喉罩-超短效麻醉藥在小兒短小手術(shù)中的應(yīng)用. 華西醫(yī)學(xué), 2010, 25(12): 2260-2262. doi: 復(fù)制
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- 1. 李師陽, 姚偉瑜, 肖全勝, 等. 患兒吸入七氟醚麻醉誘導(dǎo)的效果[J]. 中華麻醉學(xué)雜志, 2007, 27(2): 186.
- 2. 鄭洪, 譚朝華. 喉罩下吸入麻醉加骶麻在小兒尿道下裂成形術(shù)中的應(yīng)用[J]. 臨床小兒外科雜志, 2007, 6(1): 38-39.
- 3. Oczenski W, Krenn H, Dahaba AA, et al. Hemodynamic and catecholamine stress responses to insertion of the Combitube, laryngeal mask airway or tracheal intubation[J]. Anesth Analg, 1999, 88(6): 1389-1394.
- 4. Ross AK, Davis PJ, Deal GDEL, et al. Pharmacokinetics of remifentanil in anesthetized pediatric patient s undergoing elective surgery or diagnostic procedures[J]. Anesth Analg, 2001, 93(6): 1393-1401.
- 5. Spahr-Schopfer IA, Bissonnette B, Hartley EJ. Capnometry and the pediatric laryngeal mask airway[J]. Can J Anaesth, 1993, 40(4): 1038-1043.
- 6. Murat I, Billard V, Vernois J, et al. Pharmacokinetics of propofol after a single dose in children aged 1-3 years with minor burns. Comparison of three data analysis approaches[J]. Anesthesiology, 1996, 84(3): 526-532.
- 7. Martlew RA, Meakin G, Wadsworth R, et al. Dose of propofol for laryngeal mask airway insertion in children: effect of premedication with midazolam[J]. Br J Anaesth, 1996, 76(2): 308-309.