摘要
目的观察在临床麻醉深度下拔除喉罩对小儿七氟烷麻醉苏醒期躁动的影响，以探讨非药物手段防止小儿苏醒期躁动的效果。方法选取择期行下腹部手术患儿90例，ASA分级Ⅰ或Ⅱ级，按随机数字表法分为清醒状态下拔除气管导管组（ET-A组）、临床麻醉深度下拔除气管导管组（ET-D组）和临床麻醉深度下拔除喉罩组（LMA－D组），每组30例。记录术前情绪较差例数、麻醉时间、七氟烷吸入时间。记录发生苏醒期躁动例数、药物治疗情况、麻醉恢复室（PACU）停留时间。结果三组术前情绪较差率、七氟烷吸入时间、麻醉时间比较差异无统计学意义（P〉O．05）。LMA－D组苏醒期躁动率、接受药物治疗例数和PACU停留时间均明显低于ET-A组[26．7％（8／30）比66．7％（20／30）、8例比20例和（23．9±4．9）min比（32．9±5．8）min，P〈0．01]。结论小儿七氟烷麻醉时使用喉罩通气且在l临床麻醉深度下拔除喉罩可明显减少苏醒期躁动的发生，尤其适合于不宜应用药物治疗的患儿。
Objective To investigate the effect of removing laryngeal mask airway （LMA） in anaesthetized state on emergence agitation after sevoflurane anaesthesia in children. Methods Ninety children with subumbihcal operation,ASA Ⅰ or Ⅱ grade,were divided into three groups by random digits table with 30 cases each：ET-A group （endotracheal tube and extubation while awake）,ET-D group （endotracheal tube and deep extubation） and LMA-D group （insertion of LMA and deep removal）. The incidence of preoperative emotional bad,anaesthesia time,sevoflurane administration time,emergence agitation, the numbers of treated with prepofol and/or fentanyl and postoperative anaesthesia care unit（PACU ） retention time were measured. Results There was no significant difference in incidence of preoperative emotional bad, sevoflurane administration time and anaesthesia time among the three groups （P〉 0.05 ）. The incidence of emergence agitation,the numbers of treated with propofol and/or fentanyl and PACU retention time in LMA-D group were significantly lower than those in ET-A group [ 26.7%（8/30） vs. 66.7% （20/30）, 8 cases vs. 20 cases and （23.9± 4.9） min vs. （32.9 ± 5.8） min,P 〈 0.01 ]. Conclusion Insertion of LMA and removing LMA in anaesthetized state can decreased emergence agitation in children after sevoflurane anaesthesia, especially suitable for the children who do not suitable for drug treatment.
出处
《中国医师进修杂志》
2013年第6期18-20,共3页
Chinese Journal of Postgraduates of Medicine
关键词
儿童
喉面罩
麻醉
躁动
七氟烷
Child
Laryngeal mask
Anesthesia
Agitation
Sevoflurane
