摘要
目的探讨七氟醚静吸复合麻醉与丙泊酚全凭静脉麻醉对行下腹部手术患儿应激反应及术后苏醒状况的影响。方法选取2015年7月至2017年2月择期行下腹部手术治疗的患儿104例,依据术中麻醉方式不同分为试验组和对照组,每组52例。试验组采用七氟醚联合舒芬太尼静吸复合麻醉,对照组采用丙泊酚与舒芬太尼全凭静脉麻醉。比较麻醉诱导前(T1)、术后20 min(T2)、气管拔管后10 min(T3) 2组应激反应指标及血流动力学参数变化;记录并比较2组早期苏醒状况。结果 T2、T3时间点试验组血清GLU、NE、E、Cor水平均较T1显著升高,且明显高于对照组(P <0. 01); T2、T3时间点对照组血清GLU、NE无明显变化(P> 0. 05),E、Cor水平较T1降低(P <0. 05或0. 01)。试验组术后自主呼吸恢复时间、苏醒时间、拔除气管导管时间、定向力恢复时间及在PACU停留时间均较对照组明显缩短(P <0. 01)。T2、T3时间点对照组MAP、SBP、DBP均较T1时间点显著升高,且明显高于试验组(P <0. 01);试验组围术期MAP、SBP、DBP、HR、SpO_2均无明显变化(P> 0. 05)。结论七氟醚静吸复合麻醉术中血流动力学稳定,术后患儿清醒迅速,但丙泊酚全凭静脉麻醉可有效抑制围术期应激反应。
Objective To investigate the effects of sevoflurane combined with intravenous anesthesia and propofol intravenous anesthesia on stress response and postoperative awakening in children undergoing lower abdominal surgery. Methods A total of 104 children who underwent lower abdominal surgery in our hospital from July 2015 to February 2017 were enrolled in the study. According to the different types of intraoperative anesthesia, these patients were divided into experiment group （ u = 52） and control group （ u = 52 ）. The patients in experimental group were treated by sevoflurane combined with sufentanil intravenous inhalational anesthesia, however, the patients in control group were treated by propofol and sufentanil for total intravenous anesthesia. The changes of stress response indexes and hemodynanfic parameters were observed before anesthesia induction （T1） ,20 rain after surgery （T2） and 10 nfin after tracheal extubation （T3）, moreover, the early awakening status of patients was observed and compared between the two groups. Results The serum levels of GLU, NE,E and Cor at T2,T3 in experimental group were significantly increased,as cpmpared with those at T1 ,moreover,which in experimental group were significantly higher than those in control group （ P 〈 0.01 ）. There were no significant changes in serum levels of GLU and NE in control group at T2 - T3 （ P 〉 0.05 ） , and the levels of E and Cor were lower than those at T1 （P 〈0.05 or P 〈 0.01 ）. The spontaneous breathing recovery time, palinesthesia time, removal time of tracheal catheter, directional recovery time and PACU stay time in experimental group were significantly shorter than those of control group （ P 〈 0.01 ）. The levels of MAP, SBP and DBP at T2,T3 in control group were significantly increased,as compare with those at T1, which in control group were significantly higher than those in experomental group （ P 〈 0. 01 ）. In addition there were no significant changes in the levels of MAP, SBP, DBP, HR and SpO2 in experimental group at perioperative period （ P 〉 0.05 ）. Conclusion The hemodynamics during operation by sevoflurane combined with anesthesia is stable, and children awake quickly after operation. However,intravenous anesthesia with propofol can effectively inhibit the perioperative stress response.
作者
孙旺春
SUN Wangehun(Department of Anesthesia and Operation,People＇s Hospital of Kenli District,Dongying City,Shandong,Dongying 257500,China)
出处
《河北医药》
CAS
2018年第24期3756-3759,共4页
Hebei Medical Journal
关键词
小儿
麻醉
七氟醚
静脉麻醉
应激反应
苏醒状况
children
anesthesia
sevoflurane
intravenous anesthesia
stress response
palinesthesia status
